Individual provider Active NPI

Ronald Eric Glousman, M.D.

  • Orthopaedic Surgery Physician
  • Santa Ana, CA
National Provider Identifier
1104897289
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G45186 Issued in CA
Practice address
999 N Tustin Ave
Suite 114
Santa Ana, CA 92705-3528
Phone
(310) 659-9116
Fax
(866) 807-7466
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X G45186 CA
Orthopaedic Surgery Physician 207X00000X G45186 CA Primary

Addresses

Primary practice location

999 N Tustin Ave
Suite 114
Santa Ana, CA 92705-3528

Mailing address

PO Box 570627
Tarzana, CA 91357-0627
Phone (310) 659-9116

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
I20050303001005 CA Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 5799681870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald Glousman MD Medical Corporation Neuromusculoskeletal Medicine, Sports Medicine CurrentSince Jul 1, 2013 Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
House Medicine Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients

Locations

8929 Wilshire Blvd
Ste 200
Beverly Hills, CA 90211
Phone (310) 854-0283

5400 Balboa Blvd
Ste 111
Encino, CA 91316
Phone (818) 784-3125

4510 Brockton Ave
Ste 385
Riverside, CA 92501
Phone (714) 508-1981

2190 Market St
Ste A
Riverside, CA 92501
Phone (909) 824-2422

999 N Tustin Ave
Ste 114
Santa Ana, CA 92705
Phone (714) 508-1981

Interoperability endpoints

  • Direct secure messaging: ronald.glousman@3856.securemail.prognocis.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1104897289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570627",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913570627",
            "telephone_number": "310-659-9116",
            "fax_number": "866-807-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "SUITE 114",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "310-659-9116",
            "fax_number": "866-807-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOUSMAN",
        "first_name": "RONALD",
        "middle_name": "ERIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G45186",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G45186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.