Merced Orthopaedic Medical Group, Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

MERCED ORTHOPAEDIC MEDICAL GROUP, INC

Practice address

123 W North Bear Creek Dr
Merced, CA 95348-3420

Phone

(209) 722-8161

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Samuel B Tacke, MDNPI 1235236993

Title

MD

Phone

(209) 722-8161

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Samuel B Tacke, M.D.

  • Orthopaedic Surgery Physician
  • Merced, CA
  • NPI 1235236993
  Authorized official Same address or phone

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1326046012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W NORTH BEAR CREEK DRIVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-722-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W NORTH BEAR CREEK DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483420",
            "telephone_number": "209-722-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCED ORTHOPAEDIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "TACKE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "209-722-8161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ48011Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merced Medical Clinic
• Merced Medical Supply Inc
• Merced MRI Medical Group
• Merced OB GYN Care Inc
• Merced Optometry
• Merced Pathology Medical Group, Inc.
• Merced Pharmacy Care Inc (Merced Pharmacy)
• Merced Physical Therapy and Sports Medicine Rehab LLC
• Merced Pulmonary Medical Assoc.
• Merced Radiology Medical Group

• Orthopaedic Surgery Physician in Merced, CA
• Providers in Merced, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.