Organization Active NPI

Igor Jercinovich, M.D., Inc.

  • Orthopaedic Surgery Physician
  • Fallbrook, CA
National Provider Identifier
1346437258
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
IGOR JERCINOVICH, M.D., INC.
Practice address
521 E Elder St Ste 105
Fallbrook, CA 92028-3082
Phone
(760) 728-5851
Fax
(760) 728-0703
NPI assigned
Sep 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Igor A Jercinovich, M.D.NPI 1295788933
Title
Owner/Physician
Phone
(760) 728-5851

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

521 E Elder St Ste 105
Fallbrook, CA 92028-3082

Mailing address

521 E Elder St Ste 105
Fallbrook, CA 92028-3082
Phone (760) 728-5851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071017000756 CA Part B Supplier - Clinic/Group Practice 3274629530 Receives reassigned benefits from 1 practitioner
Practice locations: Murrieta, CA

National Provider Directory

National Provider Directory

Locations

25150 Hancock Ave
Murrieta, CA 92562
Phone (951) 587-3739

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1346437258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST STE 105",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283082",
            "telephone_number": "760-728-5851",
            "fax_number": "760-728-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST STE 105",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283082",
            "telephone_number": "760-728-5851",
            "fax_number": "760-728-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGOR JERCINOVICH, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "JERCINOVICH",
        "authorized_official_first_name": "IGOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "760-728-5851",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fallbrook, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.