NPIMap

Organization Active NPI

Northridge Trauma Surgeons Inc a Medical Corporation

  • Surgery Physician
  • Northridge, CA
National Provider Identifier
1255418745
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHRIDGE TRAUMA SURGEONS INC A MEDICAL CORPORATION
Practice address
18300 Roscoe Blvd
Northridge Trauma Surgeons Inc
Northridge, CA 91328
Phone
(818) 885-8500
Fax
(818) 775-0211
NPI assigned
Nov 1, 2006
Last updated
Apr 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Shawki D Saad, MDNPI 1821085689
Title
Medical Director
Phone
(818) 885-8500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X
Neurological Surgery Physician 207T00000X
Obstetrics & Gynecology Physician 207V00000X
Ophthalmology Physician 207W00000X
Orthopaedic Surgery Physician 207X00000X
Plastic Surgery Physician 208200000X
Surgery Physician 208600000X Primary
Surgery of the Hand (Surgery) Physician 2086S0105X
Plastic and Reconstructive Surgery Physician 2086S0122X
Trauma Surgery Physician 2086S0127X
Urology Physician 208800000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Addresses

Primary practice location

18300 Roscoe Blvd
Northridge Trauma Surgeons Inc
Northridge, CA 91328

Mailing address

File # 56467
Los Angeles, CA 90074
Phone (818) 885-8500

Other identifiers 1

IdentifierTypeStateIssuer
CGP155473OtherCCS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230512000129 CA Part B Supplier - Clinic/Group Practice 2567828825 Receives reassigned benefits from 15 practitioners
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Locations

File 56467
Los Angeles, CA 90074

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 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1255418745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE # 56467",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90074",
            "telephone_number": "818-885-8500",
            "fax_number": "818-775-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "address_2": "NORTHRIDGE TRAUMA SURGEONS INC",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91328",
            "telephone_number": "818-885-8500",
            "fax_number": "818-775-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE TRAUMA SURGEONS INC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "SAAD",
        "authorized_official_first_name": "SHAWKI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-885-8500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS",
            "identifier": "CGP155473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.