NPIMap

Organization Active NPI

Bass Medical Group

  • Orthopaedic Surgery Physician
  • Pleasanton, CA
National Provider Identifier
1649646282
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BASS MEDICAL GROUP
Practice address
5924 Stoneridge Dr Ste 202
Pleasanton, CA 94588-5400
Phone
(925) 600-7020
Fax
(925) 600-7010
NPI assigned
Aug 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Ms. Inez Wondeh
Title
Coo
Phone
(925) 378-4512

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X

Addresses

Primary practice location

5924 Stoneridge Dr Ste 202
Pleasanton, CA 94588-5400

Mailing address

2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 948-8143

Other identifiers 2

IdentifierTypeStateIssuer
1619916293OtherINDIVIDUAL NPI
736010002OtherNSC MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150928001192 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 9032111281 Practice locations: Pleasanton, CA

Other NPIs with the same Medicare PAC ID 12

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2309674Bass Medical Group5924 Stoneridge Sr Suite 103, Pleasanton, CA 94588Certificate of waiverAug 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Bass Medical Group22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

5924 Stoneridge Dr
Ste 202
Pleasanton, CA 94588
Phone (925) 600-7020

Practitioners & affiliated clinicians

Practitioners 292

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 292

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1649646282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2637 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-948-8143",
            "fax_number": "925-215-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5924 STONERIDGE DR STE 202",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885400",
            "telephone_number": "925-600-7020",
            "fax_number": "925-600-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "WONDEH",
        "authorized_official_first_name": "INEZ",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "925-378-4512",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619916293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NSC MEDICARE",
            "identifier": "736010002",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.