RIVERSIDE PSYCH MED GROUP
NPI 1972691228
Clinic/Center - Mental Health (Including Community Mental Health Center) in Riverside, CA
About Riverside Psych Med Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RIVERSIDE PSYCH MED GROUP (NPI 1972691228) is a healthcare organization registered as a mental health (including community mental health center) in Riverside, California and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through February 19, 2027 and lists Robert B. Summerour, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 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)
Riverside Psych Med Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Riverside Psych Med Group, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (12)
Riverside, CA 92506
Riverside, CA 92506
Riverside, CA 92506
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 05D2162307
Riverside Psychiatric Medical Group · Riverside, 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 Riverside Psychiatric Medical Group's NPI number?
The NPI number for Riverside Psychiatric Medical Group is 1972691228. It was assigned to this organization in the NPPES registry on October 11, 2006. The provider is also known as Riverside Psych Med Group.
Where is Riverside Psychiatric Medical Group located?
Riverside Psychiatric Medical Group is located at 5887 Brockton Ave Ste A Riverside Psychiatric Medical Group, Riverside, CA 92506. The listed phone number is (951) 275-8500.
What is Riverside Psychiatric Medical Group's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Riverside Psychiatric Medical Group enrolled in Medicare?
Yes. Riverside Psychiatric Medical Group is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Riverside Psychiatric Medical Group?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 3 Medicare specialties reassign their Medicare billing to Riverside Psychiatric Medical Group. 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 (6), Clinical Psychologist (4) and Psychiatry (2). Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Riverside Psychiatric Medical Group hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2162307) is associated with this NPI, valid through February 19, 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 Riverside Psychiatric Medical Group was last updated on December 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Riverside Psych Med Group · NPI 1972691228
Mental Health (Including Community Mental Health Center) organization in Riverside, California. Organization record, active in the CMS NPPES registry since October 11, 2006.
## Identity
- **NPI:** 1972691228 (Entity type: Organization)
- **Enumerated:** October 11, 2006
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Legal business name:** Riverside Psychiatric Medical Group
- **Organization subpart:** No
- **Authorized official:** Robert Summerour, OWNER
## Practice location
- **Address:** 5887 BROCKTON AVE, STE A RIVERSIDE PSYCHIATRIC MEDICAL GROUP, Riverside, CA 92506
- **Phone:** (951) 275-8500 · **Fax:** (951) 275-8560
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Clinical Psychologist (4), Psychiatry (2); 6 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 20, 2013
- **Other identifiers:** Medicare PIN ZZZ01005Z (CA)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1972691228) · Data from the CMS NPPES public registry.