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PRIME ACCESS MEDICAL GROUP
NPI 1912724048
Radiology - Vascular & Interventional Radiology in Chino, CA

Active since September 20, 2024
12611 9TH ST, CHINO, CA 91710(626) 657-8002(626) 270-4328 Get Directions Write a Review

NPPES record last updated: September 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Prime Access Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIME ACCESS MEDICAL GROUP (NPI 1912724048) is a healthcare organization registered as a vascular & interventional radiology in Chino, California and active in the NPI registry since September 2024. The organization maintains a secondary practice location in Montebello and lists Gabrielle Gonzalez, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1912724048
Entity TypeOrganization
Primary Taxonomy2085R0204X
Legal Business NamePRIME ACCESS MEDICAL GROUP
Location Address12611 9TH STChino, CA 91710-3528
Mailing Address201 W Garvey Ave Ste 102-502Monterey Park, CA 91754-7418 · (626) 657-8002
Phone(626) 657-8002
Fax(626) 270-4328
Organization SubpartNo
Authorized OfficialGabrielle GonzalezCredentialing Specialist · (909) 684-4404
Enumeration DateSeptember 20, 2024
NPPES CertifiedSeptember 19, 2024
✔ NPI 1912724048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Also ListedUrologyTaxonomy 208800000X
12611 9TH ST, Chino, CA 91710
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Secondary Practice Location 1

Location 11417 W Beverly Blvd Ste 106Montebello, CA 90640-4125 · Phone (626) 657-8002 · Fax (626) 270-4328

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prime Access Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Prime Access Medical Group, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

David Song
Urology
NPI 1699115972
5365 WALNUT AVE STE A
Chino, CA 91710
(909) 902-0009
✔ PECOS✔ Accepts Medicare0.1 mi
Victor Shi, M.D.
Interventional Radiology
NPI 1770857427
1417 W BEVERLY BLVD STE 106
Montebello, CA 90640
(626) 657-8002
✔ PECOS✔ Accepts Medicare24 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently 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 Prime Access Medical Group's NPI number?

The NPI number for Prime Access Medical Group is 1912724048. It was assigned to this organization in the NPPES registry on September 20, 2024.

Where is Prime Access Medical Group located?

Prime Access Medical Group is located at 12611 9th St, Chino, CA 91710. The listed phone number is (626) 657-8002.

What is Prime Access Medical Group's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Is Prime Access Medical Group enrolled in Medicare?

Yes. Prime Access Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prime Access Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Prime Access Medical Group, in Interventional Radiology and Urology. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Prime Access Medical Group was last updated on September 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.