Executive Medical & Surgical Associates Inc.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

EXECUTIVE MEDICAL & SURGICAL ASSOCIATES INC.

Practice address

900 E Washington St
Suite 300
Colton, CA 92324

Phone

(909) 824-2422

Fax

(909) 824-8234

NPI assigned

Jan 12, 2007

Last updated

Jul 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Darren L Bergey, MDNPI 1861464711

Title

Ceo

Phone

(909) 824-2422

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 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.

• Darren L Bergey, M.D.

  • Specialist
  • Colton, CA
  • NPI 1861464711
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1336299072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 894773",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "901894773",
            "telephone_number": "909-824-2422",
            "fax_number": "909-824-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E WASHINGTON ST",
            "address_2": "SUITE 300",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "92324",
            "telephone_number": "909-824-2422",
            "fax_number": "909-824-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE MEDICAL & SURGICAL ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "BERGEY",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-824-2422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Ewell
• Kathleen Ewing
• Excelcare Hospice Inc
• Executive Medical & Surgical Assoc. Inc.
• Executive Medical & Surgical Associates Inc. (Bergey Spine Institute)
• Julie O Eze
• Czarina Irish Facer, M.S., CCC-SLP
• Faculty Medical Group of Llusm (Faculty Medical Group of Llusm-Radiology)
• Faculty Physicians and Surgeons of Llusm
• Ambarin Salma Faizi, D.O.

• Orthopaedic Surgery of the Spine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Orthopaedic Surgery of the Spine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.