NPIMap

Organization Active NPI

Alpine Orthopaedic Medical Group Inc

  • Orthopaedic Surgery Physician
  • Stockton, CA
National Provider Identifier
1114005352
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Practice address
2488 N. California St
Stockton, CA 95204-5508
Phone
(209) 948-3333
Fax
(209) 948-3330
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Mrs. Anne Dunn McCune, MS HSA
Title
Practice Administration
Phone
(209) 946-7139

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Pediatric Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XP3100X
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0114X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X
Orthopaedic Trauma PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0801X

Addresses

Primary practice location

2488 N. California St
Stockton, CA 95204-5508

Mailing address

2488 N. California St
Stockton, CA 95204-5508
Phone (209) 948-3333

Other identifiers 4

IdentifierTypeStateIssuer
0368640001OtherCADMERC SUPPLIER NUMBER
ZZZ71793ZMedicaidCA
195690700OtherUSDL
CGP159090OtherCGP #

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041209000799 CA Part B Supplier - Clinic/Group Practice 5395701460 Receives reassigned benefits from 18 practitioners
Practice locations: Stockton, CA
O20100930051881 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5395701460 Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

333 E Alpine Ave
Stockton, CA 95204
Phone (209) 948-3333

2388 N California St
Stockton, CA 95204
Phone (209) 465-2711

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1114005352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 N. CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045508",
            "telephone_number": "209-948-3333",
            "fax_number": "209-948-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 N. CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045508",
            "telephone_number": "209-948-3333",
            "fax_number": "209-948-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE ORTHOPAEDIC MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "MCCUNE",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "DUNN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATION",
        "authorized_official_telephone_number": "209-946-7139",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS HSA"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC SUPPLIER NUMBER",
            "identifier": "0368640001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ71793Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDL",
            "identifier": "195690700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGP #",
            "identifier": "CGP159090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.