NPIMap

Organization Active NPI

Valley Orthopedic Institute Inc

  • Orthopaedic Surgery Physician
  • Ridgecrest, CA
National Provider Identifier
1487980389
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A102466 Issued in CA
Legal business name
VALLEY ORTHOPEDIC INSTITUTE INC
Practice address
1533 N Downs St
Ridgecrest, CA 93555-2456
Phone
(760) 446-2900
Fax
(760) 446-2910
NPI assigned
Oct 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Dr. Mehul Mahenra Taylor, MDNPI 1205037561
Title
President
Phone
(661) 949-8643

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 A102466 CA Primary

Addresses

Primary practice location

1533 N Downs St
Ridgecrest, CA 93555-2456

Mailing address

647 W Avenue Q
Palmdale, CA 93551-3893
Phone (661) 949-8643

Other identifiers 2

IdentifierTypeStateIssuer
1205037561MedicaidCA
1700087582MedicaidCA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100824001044 CA Part B Supplier - Clinic/Group Practice 3274663570 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Ridgecrest, CA; Palmdale, CA
O20110304000232 CA DME Supplier - Physician - General Surgery 3274663570 Practice locations: Palmdale, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

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 8

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": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1487980389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 W AVENUE Q",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513893",
            "telephone_number": "661-949-8643",
            "fax_number": "661-947-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 N DOWNS ST",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935552456",
            "telephone_number": "760-446-2900",
            "fax_number": "760-446-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY ORTHOPEDIC INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MEHUL",
        "authorized_official_middle_name": "MAHENRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-949-8643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A102466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205037561",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700087582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.