Individual provider Active NPI

Martin C Tynan, MD

  • Orthopaedic Trauma Physician
  • Orange, CA
National Provider Identifier
1639263999
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
2007032032 Issued in MO
Practice address
101 The City Drive South
Uci Medical Center
Orange, CA 92868
Phone
(714) 456-2986
NPI assigned
Oct 3, 2006
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A53822 CA
Orthopaedic Trauma Physician 207XX0801X 2007032032 MO Primary

Addresses

Primary practice location

101 The City Drive South
Uci Medical Center
Orange, CA 92868

Mailing address

PO Box 513228
Ortho Faculty of Irvine Med GR
Los Angeles, CA 90051-3228
Phone (714) 456-2986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130000476 CA Practitioner - Orthopedic Surgery 6305934266 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007032032MOMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Orthopaedic Surgery CurrentSince Dec 21, 1994 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

1640 Newport Blvd
Ste 230
Costa Mesa, CA 92627
Phone (949) 515-5210

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 29A
Orange, CA 92868
Phone (714) 456-7012

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1639263999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513228",
            "address_2": "ORTHO FACULTY OF IRVINE MED GR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513228",
            "telephone_number": "714-456-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE SOUTH",
            "address_2": "UCI MEDICAL CENTER",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNAN",
        "first_name": "MARTIN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A53822",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MO",
            "license": "2007032032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.