Organization Active NPI

San Francisco Spine Surgeons PC

  • Orthopaedic Surgery of the Spine Physician
  • San Francisco, CA
National Provider Identifier
1629657424
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
SAN FRANCISCO SPINE SURGEONS PC
Practice address
1 Shrader St Ste 600
San Francisco, CA 94117-1018
Phone
(415) 750-5845
Fax
(415) 750-8103
NPI assigned
Apr 7, 2021
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Dimitriy Kondrashov, MDNPI 1336201995
Title
Ceo
Phone
(415) 750-5845

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU
Orthopaedic Surgery of the Spine Physician 207XS0117X NU Primary

Addresses

Primary practice location

1 Shrader St Ste 600
San Francisco, CA 94117-1018

Mailing address

1 Shrader St Ste 600
San Francisco, CA 94117-1018
Phone (415) 750-5845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210622002975 CA Part B Supplier - Clinic/Group Practice 8426459983 Receives reassigned benefits from 2 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1629657424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHRADER ST STE 600",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171018",
            "telephone_number": "415-750-5845",
            "fax_number": "415-750-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHRADER ST STE 600",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171018",
            "telephone_number": "415-750-5845",
            "fax_number": "415-750-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FRANCISCO SPINE SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "KONDRASHOV",
        "authorized_official_first_name": "DIMITRIY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-750-5845",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.