Coastal Regenerative Orthopedics & Wellness Center Inc.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

Legal business name

COASTAL REGENERATIVE ORTHOPEDICS & WELLNESS CENTER INC.

Doing business as

Coastal Regenerative Orthopedics & Wellness Center

Practice address

11772 Sorrento Valley Rd Ste 100
San Diego, CA 92121-1016

Phone

(858) 221-4229

Fax

(858) 345-4828

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Victoria Marx

Title

Biller

Phone

(714) 308-4995

Specialties & licenses 1

Addresses

Other names 1

• Coastal Regenerative Orthopedics & Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20529/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Ronald Scott Cohen, M.D

  • Sports Medicine (Family Medicine) Physician
  • Oceanside, CA
  • NPI 1073588786
  Medicare reassignment

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1275165979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11772 SORRENTO VALLEY RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211016",
            "telephone_number": "858-221-4229",
            "fax_number": "858-345-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11772 SORRENTO VALLEY RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211016",
            "telephone_number": "858-221-4229",
            "fax_number": "858-345-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL REGENERATIVE ORTHOPEDICS & WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "714-308-4995"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Regenerative Orthopedics & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Regenerative Orthopedics & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Detox of Southern California LLC
• Coastal Diagnostics Inc
• Coastal Medical Group Inc
• Coastal Pain & Spinal Diagnostics Medical Group, Inc.
• Coastal Psychiatric Medical Associates, Inc.
• Coastal Serenity Psychiatry a Professional Nursing Corporation
• Coastal Skin and Eye Institute, Inc.
• Coastal Sleep Solutions San Diego, Inc.
• Coastal Speech Therapy Inc
• Coastal Sports and Wellness, Inc (Coastal Sports and Wellness Medical Center)

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.