NPIMap

Individual provider Active NPI

S. Samuel Bederman, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Orange, CA
National Provider Identifier
1316190085
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A105779 Issued in CA
Practice address
1120 W. la Veta Avenue Suite 300
Spine and Sports Specialties Medical Group
Orange, CA 92868-4246
Phone
(714) 598-1745
Fax
(714) 941-9539
NPI assigned
Oct 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X A105779 CA Primary

Addresses

Primary practice location

1120 W. la Veta Avenue Suite 300
Spine and Sports Specialties Medical Group
Orange, CA 92868-4246

Mailing address

1120 W. la Veta Avenue Suite 300
Spine and Sports Specialties Medical Group
Orange, CA 92868-4246
Phone (714) 598-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090408000360 CA Practitioner - Orthopedic Surgery 1456408434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spine and Sports Specialities Medical GroupGroup PAC ID 6507177367, 15 clinicians

Practice addresses (Care Compare)

1120 W la Veta Ave
Suite 300
Orange, CA 92868-4246
Phone (714) 598-1745

Hospital & facility affiliations

  • Grandcare Home Health Services Home health agency, Pasadena, CA, CCN 058277
  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

Merit-based Incentive Payment System (MIPS)

Final score
69.61 of 100Reported as individual
Quality
56.95
Improvement activities
40
Cost
56.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion293
Laminectomy or laminotomy (partial removal of spine bones)87
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105779CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Sports Specialities Medical Group Orthopaedic Surgery of the Spine CurrentSince Apr 1, 2016 Accepting new patients
SS Bederman MD Inc a Professional Medical Corporation Orthopaedic Surgery of the Spine CurrentSince Sep 24, 2025 Accepting new patients
University of California Irvine Past Accepting new patients
University of California San Francisco Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

31862 Coast Hwy
Ste 400
Laguna Beach, CA 92651
Phone (949) 499-8226

2618 San Miguel Dr
Newport Beach, CA 92660
Phone (888) 569-1442

1120 W La Veta Ave
Ste 300
Orange, CA 92868
Phone (657) 210-4096

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ssamuel.bederman@sass.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1316190085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W. LA VETA AVENUE SUITE 300",
            "address_2": "SPINE AND SPORTS SPECIALTIES MEDICAL GROUP",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684246",
            "telephone_number": "714-598-1745",
            "fax_number": "714-941-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W. LA VETA AVENUE SUITE 300",
            "address_2": "SPINE AND SPORTS SPECIALTIES MEDICAL GROUP",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684246",
            "telephone_number": "714-598-1745",
            "fax_number": "714-941-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDERMAN",
        "first_name": "S.",
        "middle_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A105779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.