PEDIATRIC CARDIOLOGY SPECIALISTS MEDICAL GROUP INC
NPI 1356541429
Pediatrics - Pediatric Cardiology in San Bernardino, CA
About Pediatric Cardiology Specialists Medical Group Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEDIATRIC CARDIOLOGY SPECIALISTS MEDICAL GROUP INC (NPI 1356541429) is a healthcare organization registered as a pediatric cardiology in San Bernardino, California and active in the NPI registry since July 2007. The organization holds a CLIA Waiver certificate valid through September 5, 2027 and lists Mohammad Kanakriyeh, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pediatric Cardiology Specialists Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Pediatric Cardiology Specialists Medical Group Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D2136280
Pediatric Cardiology Specialists · San Bernardino, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Pediatric Cardiology Specialists Medical Group Inc's NPI number?
The NPI number for Pediatric Cardiology Specialists Medical Group Inc is 1356541429. It was assigned to this organization in the NPPES registry on July 18, 2007. The provider is also known as Mohammad Kanakriyeh, MD.
Where is Pediatric Cardiology Specialists Medical Group Inc located?
Pediatric Cardiology Specialists Medical Group Inc is located at 350 E Vanderbilt Way Ste A, San Bernardino, CA 92408. The listed phone number is (909) 886-5200.
What is Pediatric Cardiology Specialists Medical Group Inc's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.
Is Pediatric Cardiology Specialists Medical Group Inc enrolled in Medicare?
Yes. Pediatric Cardiology Specialists Medical Group Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pediatric Cardiology Specialists Medical Group Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Cardiovascular Disease (Cardiology)) reassigns their Medicare billing to Pediatric Cardiology Specialists Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pediatric Cardiology Specialists Medical Group Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2136280) is associated with this NPI, valid through September 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Pediatric Cardiology Specialists Medical Group Inc was last updated on February 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pediatric Cardiology Specialists Medical Group Inc · NPI 1356541429
Pediatric Cardiology organization in San Bernardino, California. Organization record, active in the CMS NPPES registry since July 18, 2007.
## Identity
- **NPI:** 1356541429 (Entity type: Organization)
- **Enumerated:** July 18, 2007
- **Primary specialty:** Pediatrics - Pediatric Cardiology · taxonomy 2080P0202X
- **Also known as:** Mohammad Kanakriyeh, MD (Other Name)
- **Organization subpart:** No
- **Authorized official:** Mohammad Kanakriyeh, PRESIDENT
## Practice location
- **Address:** 350 E VANDERBILT WAY STE A, San Bernardino, CA 92408-3593
- **Phone:** (909) 886-5200 · **Fax:** (949) 336-3827
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Cardiovascular Disease (Cardiology)) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 10, 2026
- **Other identifiers:** Medicaid 1356541429 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1356541429) · Data from the CMS NPPES public registry.