Organization Active NPI

Advanced Regenerative Orthopedics

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Rafael, CA
National Provider Identifier
1083293716
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ADVANCED REGENERATIVE ORTHOPEDICS
Practice address
899 Northgate Dr Ste 400
San Rafael, CA 94903-3667
Phone
(415) 223-7504
Fax
(415) 223-7505
NPI assigned
Apr 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Authorized official

Name
Paul Handleman, DONPI 1922163179
Title
Physician/President
Phone
(415) 223-7504

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

899 Northgate Dr Ste 400
San Rafael, CA 94903-3667

Mailing address

899 Northgate Dr Ste 400
San Rafael, CA 94903-3667
Phone (415) 223-7504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210730003269 CA Part B Supplier - Clinic/Group Practice 6204245616 Receives reassigned benefits from 1 practitioner
Practice locations: San Rafael, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617840000000",
    "number": "1083293716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 NORTHGATE DR STE 400",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033667",
            "telephone_number": "415-223-7504",
            "fax_number": "415-223-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 NORTHGATE DR STE 400",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033667",
            "telephone_number": "415-223-7504",
            "fax_number": "415-223-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REGENERATIVE ORTHOPEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "HANDLEMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "415-223-7504",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.