NPIMap

Organization Active NPI

California Sports and Orthopaedic

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Orinda, CA
National Provider Identifier
1649433962
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
G63226 Issued in CA
Legal business name
CALIFORNIA SPORTS AND ORTHOPAEDIC
Practice address
25 Orinda Way
Suite 100-a
Orinda, CA 94563-4403
Phone
(925) 258-9571
Fax
(925) 258-9572
NPI assigned
Jul 7, 2008
Last updated
Oct 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Dr. Robert A Eppley, MDNPI 1497784888
Title
Senior Partner
Phone
(510) 704-7760

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
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207XX0005X G63226 CA Primary

Addresses

Primary practice location

25 Orinda Way
Suite 100-a
Orinda, CA 94563-4403

Mailing address

2999 Regent St
Suite 225
Berkeley, CA 94705-2190
Phone (510) 704-7760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050303001053 CA Part B Supplier - Clinic/Group Practice 3779537550 Receives reassigned benefits from 16 practitioners
Practice locations: Berkeley, CA; Oakland, CA; Orinda, CA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

350 30th St
Ste 530
Oakland, CA 94609
Phone (510) 422-5150

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1649433962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST",
            "address_2": "SUITE 225",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052190",
            "telephone_number": "510-704-7760",
            "fax_number": "510-704-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ORINDA WAY",
            "address_2": "SUITE 100-A",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945634403",
            "telephone_number": "925-258-9571",
            "fax_number": "925-258-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA SPORTS AND ORTHOPAEDIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "EPPLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "510-704-7760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G63226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.