Medical Center for Bone and Joint Disorders

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MEDICAL CENTER FOR BONE AND JOINT DISORDERS

Practice address

400 N. Mountain Avenue #310
Upland, CA 91786

Phone

(909) 920-0876

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Scott Goldman, M.D.

Title

President

Phone

(909) 920-0876

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 5

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

• I Scott Goldman, MD

  • Orthopaedic Surgery Physician
  • Upland, CA
  • NPI 1194820423
  Medicare reassignment Care Compare group NPD
• Dane George Johnson, DPT

  • Physical Therapist
  • Upland, CA
  • NPI 1639750326
  Medicare reassignment Care Compare group NPD
• Frantz Forbes Despas Jr., PA-C

  • Physician Assistant
  • Upland, CA
  • NPI 1417288275
  Medicare reassignment Care Compare group
• Laura Fahey, PT, DPT

  • Physical Therapist
  • El Monte, CA
  • NPI 1669421087
  Medicare reassignment NPD
• Nariba Maycock Gibson, DPT

  • Physical Therapist
  • Yucaipa, CA
  • NPI 1568446771
  Medicare reassignment NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245336403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MOUNTAIN AVENUE",
            "address_2": "#310",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-920-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N. MOUNTAIN AVENUE #310",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-920-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER FOR BONE AND JOINT DISORDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-920-0876",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD INSURANCE ID",
            "identifier": "ZZZ61119Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul T McMahon, PH.D.
• Mackenzie McNutt
• Theodora McQueen
• MD Zuniga Inc.
• Medcare Plus Home Health Providers, Inc.
• Medical Logistics
• Medical Logistics
• Medical Youth Fountain Incorporated
• Medicare Transit Inc
• Gerardo Antonio Medina

• Specialist in Upland, CA
• Providers in Upland, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.