HEACOCK HEALTH MEDICAL GROUP, INC.
NPI 1891251849
Clinic/Center - Urgent Care in Moreno Valley, CA
About Heacock Health Medical Group, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HEACOCK HEALTH MEDICAL GROUP, INC. (NPI 1891251849) is a healthcare organization registered as an urgent care in Moreno Valley, California and active in the NPI registry since February 2019. The organization holds a CLIA Waiver certificate valid through May 17, 2028 and lists Rafael Penunuri, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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)
Heacock Health Medical Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Heacock Health Medical Group, Inc., which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (6)
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 05D2344150
Heacock Health Medical Group Inc · Rialto, 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 Heacock Health Medical Group, Inc.'s NPI number?
The NPI number for Heacock Health Medical Group, Inc. is 1891251849. It was assigned to this organization in the NPPES registry on February 14, 2019.
Where is Heacock Health Medical Group, Inc. located?
Heacock Health Medical Group, Inc. is located at 24060 Fir Ave Ste A, Moreno Valley, CA 92553. The listed phone number is (951) 247-8005.
What is Heacock Health Medical Group, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.
Is Heacock Health Medical Group, Inc. enrolled in Medicare?
Yes. Heacock Health Medical Group, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Heacock Health Medical Group, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 4 Medicare specialties reassign their Medicare billing to Heacock Health 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. The largest specialties are Nurse Practitioner (3), Emergency Medicine (1) and Family Practice (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Heacock Health Medical Group, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2344150) is associated with this NPI, valid through May 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Heacock Health Medical Group, Inc. was last updated on April 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Heacock Health Medical Group, Inc. · NPI 1891251849
Urgent Care organization in Moreno Valley, California. Organization record, active in the CMS NPPES registry since February 14, 2019.
## Identity
- **NPI:** 1891251849 (Entity type: Organization)
- **Enumerated:** February 14, 2019
- **Primary specialty:** Clinic/Center - Urgent Care · taxonomy 261QU0200X
- **Organization subpart:** No
- **Authorized official:** Rafael Penunuri, MEDICAL DIRECTOR
## Practice location
- **Address:** 24060 FIR AVE STE A, Moreno Valley, CA 92553-2895
- **Phone:** (951) 247-8005 · **Fax:** (951) 247-8007
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Emergency Medicine (1), Family Practice (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 15, 2025
- **Other identifiers:** Medicaid 1760896336 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1891251849) · Data from the CMS NPPES public registry.