Organization Active NPI

Aristamd Medical Group PA

  • Orthopaedic Surgery Physician
  • San Diego, CA
National Provider Identifier
1396534095
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ARISTAMD MEDICAL GROUP PA
Practice address
4660 La Jolla Village Dr
San Diego, CA 92122-4601
Phone
(858) 751-4777
NPI assigned
May 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Jordan Coleman
Title
Clinical Operations
Phone
(858) 751-4777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

4660 La Jolla Village Dr
San Diego, CA 92122-4601

Mailing address

4660 La Jolla Village Dr Ste 100
San Diego, CA 92122-4604
Phone (858) 751-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260217000034 FL Part B Supplier - Clinic/Group Practice 5597245803 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Petersburg, FL
O20260421001295 GA Part B Supplier - Clinic/Group Practice 5597245803 Receives reassigned benefits from 1 practitioner
Practice locations: Locust Grove, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1396534095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 LA JOLLA VILLAGE DR STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921224604",
            "telephone_number": "858-751-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921224601",
            "telephone_number": "858-751-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARISTAMD MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "858-751-4777"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.