Individual provider Active NPI

Nicholas Joseph Prindeze, MD

  • Surgery Physician
  • Glendora, CA
National Provider Identifier
1316407158
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A194732 Issued in CA
Practice address
353 W Foothill Blvd
Glendora, CA 91741-5309
Phone
(909) 757-8425
Fax
(909) 757-8392
NPI assigned
Mar 20, 2019
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A194732 CA Primary

Addresses

Primary practice location

353 W Foothill Blvd
Glendora, CA 91741-5309

Mailing address

353 W Foothill Blvd
Glendora, CA 91741-5309
Phone (909) 757-8425

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820003620 CA Practitioner - General Surgery 0840790309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Surgeons of Orange a Medical GroupGroup PAC ID 6901705227, 116 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 634-5549

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A194732CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Surgeons of Orange a Medical Group Surgery CurrentSince Aug 1, 2025 Accepting new patients
Ali Abidali DO Professional Medical Corporation Surgery CurrentSince Sep 1, 2026 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

353 W Foothill Blvd
Glendora, CA 91741
Phone (626) 857-7344

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 22C
Orange, CA 92868
Phone (714) 456-2249

400 N Mountain Ave
Ste 215
Upland, CA 91786

Organizations & group practices 3

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

Hospital & facility affiliations 2

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1316407158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917415309",
            "telephone_number": "909-757-8425",
            "fax_number": "909-757-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917415309",
            "telephone_number": "909-757-8425",
            "fax_number": "909-757-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINDEZE",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A194732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.