NPIMap

Organization Active NPI

Tri-Valley Orthopedic and Sports Medical Group Inc

Doing business as Tri-Valley Orthopedic Specialists Inc

  • Orthopaedic Surgery Physician
  • Pleasanton, CA
National Provider Identifier
1184808156
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TRI-VALLEY ORTHOPEDIC AND SPORTS MEDICAL GROUP INC
Doing business as
Tri-Valley Orthopedic Specialists Inc
Practice address
4626 Willow Rd
Suite 200
Pleasanton, CA 94588-2710
Phone
(925) 463-0470
Fax
(925) 463-0473
NPI assigned
Dec 26, 2007
Last updated
Nov 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Authorized official

Name
Deborah Rhoton
Title
Billing Department Manager
Phone
(925) 469-0939

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary
Orthopedic Physical Therapist 2251X0800X
Hand Occupational Therapist 225XH1200X

Addresses

Primary practice location

4626 Willow Rd
Suite 200
Pleasanton, CA 94588-2710

Mailing address

4626 Willow Rd
Suite 200
Pleasanton, CA 94588-2710
Phone (925) 469-0939

Other names 1

  • Tri-Valley Orthopedic Specialists Inc Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031219000786 CA Part B Supplier - Clinic/Group Practice 3577461151 Receives reassigned benefits from 29 practitioners
4 other NPIs on this enrollment
Practice locations: Pleasanton, CA; San Ramon, CA; Tracy, CA
O20100930036615 CA DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 3577461151 Practice locations: Pleasanton, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

315 S Abbott Ave
Milpitas, CA 95035
Phone (408) 790-2900

5601 Norris Canyon Rd
Ste 130
San Ramon, CA 94583
Phone (925) 463-0470

5601 Norris Canyon Rd
Ste 130A
San Ramon, CA 94583

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 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1184808156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 WILLOW RD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882710",
            "telephone_number": "925-469-0939",
            "fax_number": "925-469-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 WILLOW RD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882710",
            "telephone_number": "925-463-0470",
            "fax_number": "925-463-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-VALLEY ORTHOPEDIC AND SPORTS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "RHOTON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "BILLING DEPARTMENT MANAGER",
        "authorized_official_telephone_number": "925-469-0939"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-Valley Orthopedic Specialists Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.