Orthopedic Surgery Center of Oc LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

060000520 Issued in CA

Legal business name

ORTHOPEDIC SURGERY CENTER OF OC LLC

Practice address

22 Corporate Plaza
#150
Newport Beach, CA 92660

Phone

(949) 515-0708

Fax

(949) 515-4821

NPI assigned

May 23, 2005

Last updated

Sep 25, 2023By 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

Russell Petrie, M.D.

Title

Chairman

Phone

(949) 782-5038

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Listed as

Orthopedic Surgery Center of Oc LLCCCN 05C0001445

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Orthopedic Surgery Center of Oc LLC Dba Hoag Orthopedic Institute Surgery CenterCCN 55C0001160

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300

  Member Of

  NPD member
• Hoag Orthopedic Institute LLC

  • Special Hospital
  • Irvine, CA
  • NPI 1982927877

  Member Of

  NPD member
• Newport Orthopedic Institute, a Medical Corporation

  • Durable Medical Equipment & Medical Supplies
  • Newport Beach, CA
  • NPI 1396966354

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1386647527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CORPORATE PLAZA #150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-515-0708",
            "fax_number": "949-515-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CORPORATE PLAZA",
            "address_2": "#150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-515-0708",
            "fax_number": "949-515-4821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Mareblu Ste 100",
            "address_purpose": "LOCATION",
            "city": "Aliso Viejo",
            "state": "CA",
            "postal_code": "926563046",
            "country_code": "US",
            "telephone_number": "949-658-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPEDIC SURGERY CENTER OF OC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "949-782-5038",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "060000520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ60061Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051445",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Fielder Orris, PSY.D
• Timothy Ortega, RADT-1
• Orthopedic Institute of Newport Beach Limited Partnership (Newport Orthopedic Institute)
• Orthopedic Institute of Newport Beach Limited Partnership (Newport Orthopedic Institute)
• Orthopedic Specialists of Newport Beach
• Orthowest
• Destinee Ortiz
• Evelyn Ortiz
• Valerie Ortiz
• Oscar H. Oo, Psy.D. a Professional Psychological Corporation (Logical Behavioral Health)

• Ambulatory Surgical Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.