San Jose Sports Medicine & Orthopedics

Primary specialty

SpecialistTaxonomy code 174400000X

License

G56561 Issued in CA

Legal business name

SAN JOSE SPORTS MEDICINE & ORTHOPEDICS

Practice address

2430 Samaritan Dr
San Jose, CA 95124-3907

Phone

(408) 371-5300

Fax

(408) 371-6387

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Authorized official

Name

Leo B Semkiw, M.D.NPI 1215949110

Title

President

Phone

(408) 371-5300

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Leo B Semkiw, M.D.

  • Specialist
  • San Jose, CA
  • NPI 1215949110
  Medicare reassignment NPD Authorized official
• Mary Magdalene Brkich

  • Surgical Physician Assistant
  • San Jose, CA
  • NPI 1558472902
  Medicare reassignment

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1245247196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243907",
            "telephone_number": "408-371-5300",
            "fax_number": "408-371-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243907",
            "telephone_number": "408-371-5300",
            "fax_number": "408-371-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE SPORTS MEDICINE & ORTHOPEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "SEMKIW",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-371-5300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G56561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "00G565611",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEO SEMKIW M.D. INDIVIDUAL NPI",
            "identifier": "1215949110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONICA SWEET PA INDIVIDUAL NPI",
            "identifier": "1881615334",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• San Jose Orthopedic Associates Medical Corporation
• San Jose Pacific Neurology CNTR Prof Cor
• San Jose Physical Therapy Incorporated
• San Jose Pulmonary Associates
• San Jose Refractive, LLC
• San Jose State University Student Health Center
• San Jose Surgical Group
• San Jose Therapy, a Licensed Clinical Social Worker Corporation
• San Jose Usd
• San Jose Womens Medical Group Inc

• Specialist in San Jose, CA
• Providers in San Jose, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.