Organization Active NPI

San Dieguito Orthopedic Medical Center P C

  • Orthopaedic Surgery Physician
  • Encinitas, CA
National Provider Identifier
1356433965
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SAN DIEGUITO ORTHOPEDIC MEDICAL CENTER P C
Practice address
332 Santa Fe Drive
Suite 110
Encinitas, CA 92024
Phone
(760) 943-6700
Fax
(760) 632-4292
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Robert Ira Gelb, MDNPI 1710079314
Title
Board Member
Phone
(760) 943-6700

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Adult Reconstructive Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0114X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

332 Santa Fe Drive
Suite 110
Encinitas, CA 92024

Mailing address

332 Santa Fe Drive
Suite 110
Encinitas, CA 92024
Phone (760) 943-6700

Other practice location 1

6121 Paseo Del Norte Ste 100
Carlsbad, CA 92011-1161
Phone (760) 448-2488

Other practice location 2

477 N El Camino Real Ste C100
Encinitas, CA 92024-1332
Phone (760) 942-8800

Other practice location 3

637 E Grand Ave Fl 2
Escondido, CA 92025-4402
Phone (760) 943-6700

Other practice location 4

2451A Impala Dr
Carlsbad, CA 92010-7227
Phone (760) 918-2322

Other practice location 5

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Other practice location 6

320 Santa Fe Dr Ste Ll2
Encinitas, CA 92024-5140
Phone (760) 632-3900

Other practice location 7

637 E Grand Ave
Escondido, CA 92025-4402
Phone (760) 943-6700

Other practice location 8

354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone (760) 633-6501

Other practice location 9

332 Santa Fe Dr Ste 120
Encinitas, CA 92024-5143
Phone (760) 942-4400

Other identifiers 2

IdentifierTypeStateIssuer
GR0093170MedicaidCA
ZZZ04918ZOtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040524001507 CA Part B Supplier - Clinic/Group Practice 0143201442 Receives reassigned benefits from 28 practitioners
7 other NPIs on this enrollment
Practice locations: Encinitas, CA; San Diego, CA; Oceanside, CA; Escondido, CA; Carlsbad, CA
O20100930037320 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0143201442 Practice locations: Encinitas, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2451 Impala Dr
Carlsbad, CA 92010
Phone (760) 942-4400

2451 Impala Dr
#A
Carlsbad, CA 92010
Phone (760) 918-2322

2451 Impala Dr
Ste A
Carlsbad, CA 92010

320 Santa Fe Dr
Ste LL2
Encinitas, CA 92024
Phone (760) 612-6647

320 Santa Fe Dr
Ste LL4
Encinitas, CA 92024
Phone (760) 642-7009

543 Encinitas Blvd
Ste 105
Encinitas, CA 92024
Phone (760) 291-7025

637 E Grand Ave
Fl 2
Escondido, CA 92025
Phone (760) 943-6700

4002 Vista Way
Oceanside, CA 92056
Phone (760) 724-8411

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1356433965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 SANTA FE DRIVE",
            "address_2": "SUITE 110",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-943-6700",
            "fax_number": "760-632-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 SANTA FE DRIVE",
            "address_2": "SUITE 110",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-943-6700",
            "fax_number": "760-632-4292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6121 Paseo Del Norte Ste 100",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920111161",
            "country_code": "US",
            "telephone_number": "760-448-2488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "477 N El Camino Real Ste C100",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920241332",
            "country_code": "US",
            "telephone_number": "760-942-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "637 E Grand Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920254402",
            "country_code": "US",
            "telephone_number": "760-943-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2451A Impala Dr",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920107227",
            "country_code": "US",
            "telephone_number": "760-918-2322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Frost St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921232701",
            "country_code": "US",
            "telephone_number": "858-939-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Santa Fe Dr Ste Ll2",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245140",
            "country_code": "US",
            "telephone_number": "760-632-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "637 E Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920254402",
            "country_code": "US",
            "telephone_number": "760-943-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "354 Santa Fe Dr",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245142",
            "country_code": "US",
            "telephone_number": "760-633-6501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "332 Santa Fe Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920245143",
            "country_code": "US",
            "telephone_number": "760-942-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAN DIEGUITO ORTHOPEDIC MEDICAL CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GELB",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "760-943-6700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ04918Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.