Individual provider Active NPI

Parke William Hudson, MD

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
National Provider Identifier
1104310358
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A163639 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Jun 20, 2018
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A163639 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

23452 Toronja Corte
Corona, CA 92883-9369
Phone (925) 212-2113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918002761 CA Practitioner - Orthopedic Surgery 5597206557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Un of California, Riverside, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sac Health SystemGroup PAC ID 4385533579, 222 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

250 S G St
San Bernardino, CA 92410-3320
Phone (909) 382-7100

25455 Barton Rd
Loma Linda, CA 92354-3128
Phone (909) 558-2808

488 S K St
San Bernardino, CA 92410-2641
Phone (909) 383-8092

900 E Washington St
Suite 200
Colton, CA 92324-4192
Phone (909) 558-4000

File Number
Suite 54701
Los Angeles, CA 90074-4701

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement26
Knee replacement22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A163639CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Nov 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2024 Accepting new patients
Sac Health System CurrentSince Nov 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Orthopaedic Surgery Past Accepting new patients

Locations

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11406 Loma Linda Dr
Ste 300
Loma Linda, CA 92354
Phone (909) 558-6277

25455 Barton Rd
Loma Linda, CA 92354
Phone (909) 558-2808

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1104310358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23452 TORONJA CORTE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928839369",
            "telephone_number": "925-212-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "PARKE",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A163639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.