NPIMap

Organization Active NPI

Corona Orthopaedic Associates Medical Group Inc

  • Orthopaedic Surgery Physician
  • Corona, CA
National Provider Identifier
1598872657
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CORONA ORTHOPAEDIC ASSOCIATES MEDICAL GROUP INC
Practice address
341 Magnolia Avenue
Suite 101
Corona, CA 92879-3331
Phone
(951) 735-6060
Fax
(951) 735-4510
NPI assigned
Aug 24, 2006
Last updated
Feb 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Authorized official

Name
Bradley Lloyd Baum, MDNPI 1205847654
Title
Secretary
Phone
(951) 735-6060

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 Physician 207X00000X NU Primary

Addresses

Primary practice location

341 Magnolia Avenue
Suite 101
Corona, CA 92879-3331

Mailing address

341 Magnolia Avenue
Suite 101
Corona, CA 92879-3331
Phone (951) 735-6060

Other identifiers 4

IdentifierTypeStateIssuer
ZZZ51830ZOtherBLUE SHIELD OF CALIFORNIA
CI7854OtherRAIL ROAD MEDICARE
925392BMedicaidCA
GR0070300MedicaidCA

Other names 1

  • Corona-Temecula Orthopaedic Associates Medical Group Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040610000656 CA Part B Supplier - Clinic/Group Practice 0547243586 Receives reassigned benefits from 18 practitioners
Practice locations: Corona, CA; Murrieta, CA
O20101221000767 CA DME Supplier - Physician - Unknown Physician Specialty 0547243586 Practice locations: Corona, CA

National Provider Directory

National Provider Directory

Locations

341 Magnolia Ave
Ste 103
Corona, CA 92879
Phone (951) 600-7702

28078 Baxter Rd
Ste 101
Murrieta, CA 92563

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1598872657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVENUE",
            "address_2": "SUITE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793331",
            "telephone_number": "951-735-6060",
            "fax_number": "951-735-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVENUE",
            "address_2": "SUITE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793331",
            "telephone_number": "951-735-6060",
            "fax_number": "951-735-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA ORTHOPAEDIC ASSOCIATES MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "BAUM",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "951-735-6060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ51830Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CI7854",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "925392B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0070300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona-Temecula Orthopaedic Associates Medical Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Corona-Temecula Orthopaedic Associates Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.