NPIMap

Individual provider Active NPI

Gregory D. Carlson, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Orange, CA
National Provider Identifier
1215924329
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G65319 Issued in CA
Practice address
1120 W. la Veta Avenue
Suite 300
Orange, CA 92868-4246
Phone
(714) 598-1745
Fax
(714) 941-9539
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G65319 CA
Orthopaedic Surgery of the Spine Physician 207XS0117X G65319 CA Primary

Addresses

Primary practice location

1120 W. la Veta Avenue
Suite 300
Orange, CA 92868-4246

Mailing address

1120 W la Veta Ave Ste 300
Orange, CA 92868-4246
Phone (714) 598-1745

Other identifiers 1

IdentifierTypeStateIssuer
CB234935OtherCAINDIVIDUAL PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091229000452 CA Practitioner - Orthopedic Surgery 7416843057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Loma Linda University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spine and Sports Specialities Medical GroupGroup PAC ID 6507177367, 15 clinicians

Practice addresses (Care Compare)

1120 W la Veta Ave
Suite 300
Orange, CA 92868-4246
Phone (714) 598-1745

Hospital & facility affiliations

  • Hollywood Home Health Services Home health agency, N Hollywood, CA, CCN 058310
  • Grandcare Home Health Services Home health agency, Pasadena, CA, CCN 058277
  • N & D Healthcare Services Inc Home health agency, Pasadena, CA, CCN 058255
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Merit-based Incentive Payment System (MIPS)

Final score
79.95 of 100Reported as individual
Quality
76.51
Improvement activities
40
Cost
64.47

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion260
Laminectomy or laminotomy (partial removal of spine bones)136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G65319CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Sports Specialities Medical Group Orthopaedic Surgery CurrentSince Jun 1, 2015 Accepting new patients

Locations

1120 W La Veta Ave
Ste 300
Orange, CA 92868
Phone (657) 210-4096

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: greg.carlson@sass.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 8

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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1215924329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W LA VETA AVE STE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684246",
            "telephone_number": "714-598-1745",
            "fax_number": "714-941-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W. LA VETA AVENUE",
            "address_2": "SUITE 300",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684246",
            "telephone_number": "714-598-1745",
            "fax_number": "714-941-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "GREGORY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G65319",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G65319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "CB234935",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.