Individual provider Active NPI

James B Reynolds, MD

  • Orthopaedic Surgery of the Spine Physician
  • Daly City, CA
National Provider Identifier
1194797357
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G18657 Issued in CA
Practice address
455 Hickey Blvd Ste 310
Daly City, CA 94015-2630
Phone
(650) 985-7500
Fax
(650) 731-4434
NPI assigned
Feb 2, 2006
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X G18657 CA Primary

Addresses

Primary practice location

455 Hickey Blvd Ste 310
Daly City, CA 94015-2630

Mailing address

455 Hickey Blvd Ste 310
Daly City, CA 94015-2630
Phone (650) 985-7500

Other identifiers 1

IdentifierTypeStateIssuer
GR0041210MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000338 CA Practitioner - Orthopedic Surgery 6709859010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 1969
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1850 Sullivan Ave
Suite 200
Daly City, CA 94015-2204

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion29
Laminectomy or laminotomy (partial removal of spine bones)23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G18657CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Orthopedic Associates, Inc. Orthopaedic Surgery of the Spine CurrentSince Dec 18, 2020 Accepting new patients

Locations

1850 Sullivan Ave
Ste 330
Daly City, CA 94015
Phone (650) 756-5630

455 Hickey Blvd
Ste 310
Daly City, CA 94015
Phone (650) 339-1000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 3

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1194797357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 HICKEY BLVD STE 310",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152630",
            "telephone_number": "650-985-7500",
            "fax_number": "650-731-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 HICKEY BLVD STE 310",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152630",
            "telephone_number": "650-985-7500",
            "fax_number": "650-731-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JAMES",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G18657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0041210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.