Organization Active NPI

Haider Spine Center Medical Group Inc

  • Orthopaedic Surgery of the Spine Physician
  • Riverside, CA
National Provider Identifier
1023079183
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G61537 Issued in CA
Legal business name
HAIDER SPINE CENTER MEDICAL GROUP INC
Practice address
6276 River Crest Dr
Riverside, CA 92507-0754
Phone
(952) 141-3020
Fax
(951) 653-5161
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas T Haider, M.D.NPI 1336100379
Title
President
Phone
(951) 413-0964

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 20A8197 CA
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X G61537 CA Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X A107599 CA
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X G81353 CA
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA18101 CA

Addresses

Primary practice location

6276 River Crest Dr
Riverside, CA 92507-0754

Mailing address

6276 River Crest Dr Ste a
Riverside, CA 92507-0754
Phone (951) 413-0200

Other identifiers 2

IdentifierTypeStateIssuer
1740213594OtherCACHAD SWEETNAM
GR0086790MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040421000675 CA Part B Supplier - Clinic/Group Practice 3072509546 Receives reassigned benefits from 6 practitioners
Practice locations: Corona, CA; Riverside, CA
O20100930073103 CA DME Supplier - Physician - General Surgery 3072509546 Practice locations: Riverside, CA

National Provider Directory

National Provider Directory

Locations

26520 Cactus Ave
Rm E152
Moreno Valley, CA 92555
Phone (909) 486-6583

6276 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 413-0200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765238400000",
    "number": "1023079183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6276 RIVER CREST DR STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070754",
            "telephone_number": "951-413-0200",
            "fax_number": "951-653-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 RIVER CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070754",
            "telephone_number": "952-141-3020",
            "fax_number": "951-653-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAIDER SPINE CENTER MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A",
        "authorized_official_last_name": "HAIDER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-413-0964",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "20A8197",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G61537",
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A107599",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G81353",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA18101",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAD SWEETNAM",
            "identifier": "1740213594",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0086790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.