NPIMap

Individual provider Active NPI

Thomas T Haider, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Riverside, CA
National Provider Identifier
1336100379
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G61537 Issued in CA
Practice address
6276 River Crest Dr
Riverside, CA 92507-0754
Phone
(951) 413-0200
Fax
(951) 653-5161
NPI assigned
Mar 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 G61537 CA Primary

Addresses

Primary practice location

6276 River Crest Dr
Riverside, CA 92507-0754

Mailing address

2357 Knob Hill Dr
Riverside, CA 92506-3440
Phone (951) 682-3623

Other identifiers 2

IdentifierTypeStateIssuer
GR0086790MedicaidCA
00G615370MedicaidCA

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
I20081205000570 CA Practitioner - Orthopedic Surgery 6305832874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Haider Spine Center Medical Group IncGroup PAC ID 3072509546, 5 clinicians

Practice addresses (Care Compare)

6276 River Crest Dr
Suite a
Riverside, CA 92507-0754
Phone (951) 413-0200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion17
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Haider Spine Center Medical Group Inc Orthopaedic Surgery CurrentSince Dec 31, 1988 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Haider Spine Center Medical Group Inc Past Accepting new patients

Locations

6276 River Crest Dr
Riverside, CA 92507
Phone (951) 413-0200

6276 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 413-0200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336100379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 KNOB HILL DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063440",
            "telephone_number": "951-682-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 RIVER CREST DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070754",
            "telephone_number": "951-413-0200",
            "fax_number": "951-653-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDER",
        "first_name": "THOMAS",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G61537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0086790",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G615370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.