Community Orthopedic Medical Group

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G42640 Issued in CA

Legal business name

COMMUNITY ORTHOPEDIC MEDICAL GROUP

Practice address

26401 Crown Valley Pkwy
Suite 101
Mission Viejo, CA 92691-6350

Phone

(949) 348-4000

NPI assigned

Apr 28, 2006

Last updated

Oct 15, 2021By 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

Jerald P Waldman, MDNPI 1659339414

Title

President

Phone

(949) 348-4000

Specialties & licenses 10

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Richards Physical Therapy Inc

  dba Professional Physical Therapy

  • Orthotic Fitter
  • Mission Viejo, CA
  • NPI 1285820183

  Member Of

  NPD member
• Richards Physical Therapy Inc

  dba DBA Professional Physical Therapy

  • Physical Therapist
  • Mission Viejo, CA
  • NPI 1528065588

  Member Of

  NPD member

Locations

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 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael D Burdi, MD

  • Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1801853189
  Medicare reassignment Care Compare group NPD
• James Benjamin Chen, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1104210152
  Medicare reassignment Care Compare group NPD
• Stephen T Gardner, M.D.

  • Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1871753392
  Medicare reassignment Care Compare group NPD
• Evan Michael Guerrero, M.D.

  • Orthopaedic Hand Surgery Physician
  • Mission Viejo, CA
  • NPI 1346635125

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Tiva Hanjan, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Mission Viejo, CA
  • NPI 1689729253
  Medicare reassignment Care Compare group NPD
• Michael S Marandola, MD

  • Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1013974393
  Medicare reassignment Care Compare group NPD
• Kent S Marangi, MD

  • Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1477510758
  Medicare reassignment Care Compare group NPD
• John R Morris, MD

  • Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1396703161
  Medicare reassignment Care Compare group NPD
• Stephen Leonard Tocci, MD

  • Orthopaedic Surgery Physician
  • Mission Viejo, CA
  • NPI 1588771745
  Medicare reassignment Care Compare group NPD
• Neal Washburn, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Mission Viejo, CA
  • NPI 1487067369
  Medicare reassignment Care Compare group NPD
• Sydney Alyssa Cohen

  • Physician Assistant
  • Mission Viejo, CA
  • NPI 1437986171
  Medicare reassignment Care Compare group
• Connor Galbraith

  • Physician Assistant
  • Mission Viejo, CA
  • NPI 1619783156
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1508823873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916350",
            "telephone_number": "949-348-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26401 CROWN VALLEY PKWY",
            "address_2": "SUITE 101",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916350",
            "telephone_number": "949-348-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ORTHOPEDIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "WALDMAN",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-348-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G42640",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G63599",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G69562",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G64377",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "G74361",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G25458",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A70607",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "A108023",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A64745",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A80044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ24045Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Raymond Coleman, AU.D.
• Rachel Coleman, M.A., MFT
• Collective Centre of Psychology, Inc.
• Shakayla Collins
• Arlene Cory Colon, M.A, CCC-SLP
• Complete Care Family Medicine
• Complete Care Family Medicine and Skin Center
• Complete Care Family Medicine and Skin Center
• Mark Guy Condell, OD
• Kosta Paul Condous

• Orthopaedic Surgery Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.