NPIMap

Organization Active NPI

Pacific Orthopaedics & Sports Medicine

  • Orthopaedic Surgery Physician
  • Encinitas, CA
National Provider Identifier
1265507248
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PACIFIC ORTHOPAEDICS & SPORTS MEDICINE
Practice address
351 Santa Fe Dr
Suite 100
Encinitas, CA 92024-5137
Phone
(760) 633-3130
Fax
(760) 633-3546
NPI assigned
Nov 22, 2006
Last updated
Mar 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Authorized official

Name
Stephen P. Nichols, M.D.
Title
Partner
Phone
(760) 633-3130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

351 Santa Fe Dr
Suite 100
Encinitas, CA 92024-5137

Mailing address

PO Box 1240
Cardiff, CA 92007-7240
Phone (760) 633-3130

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ62507ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1265507248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1240",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920077240",
            "telephone_number": "760-633-3130",
            "fax_number": "760-633-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SANTA FE DR",
            "address_2": "SUITE 100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245137",
            "telephone_number": "760-633-3130",
            "fax_number": "760-633-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ORTHOPAEDICS & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "760-633-3130",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ62507Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.