Individual provider Active NPI

Vic A Osborne, M.D.

  • Orthopaedic Surgery Physician
  • West Covina, CA
National Provider Identifier
1659317733
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A45453 Issued in CA
Practice address
1135 S Sunset Ave Ste 200
West Covina, CA 91790
Phone
(626) 918-6655
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A45453 CA Primary

Addresses

Primary practice location

1135 S Sunset Ave Ste 200
West Covina, CA 91790

Mailing address

1050 Lakes Dr
Suite 100
West Covina, CA 91790-2924
Phone (626) 918-6655

Other practice location 1

1125 Via Verde
San Dimas, CA 91773-4400
Phone (909) 599-6126

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
I20040908001023 CA Practitioner - Orthopedic Surgery 9537155841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Baylor College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanate Health Medical Care FoundationGroup PAC ID 9830544980, 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

1305 W Arrow Hwy
Suite 104
San Dimas, CA 91773-2337
Phone (909) 394-9004

Hospital & facility affiliations

  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597
  • Casa Colina Hospital Hospital, Pomona, CA, CCN 050782

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
60.04
Promoting interoperability
87
Improvement activities
40
Cost
69.31

Merit-based Incentive Payment System (MIPS)

Final score
82.35 of 100Reported as group
Quality
52.92
Promoting interoperability
93
Improvement activities
40
Cost
70.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Spinal fusion1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45453CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Group Current Accepting new patients
Emanate Health Medical Group CurrentSince Jan 1, 2017 Accepting new patients
Emanate Health Medical Care Foundation Orthopaedic Surgery CurrentSince Jan 1, 2024 Accepting new patients
Citrus Valley Physician Partners CurrentSince Jan 1, 2017 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

14375 Pipeline Ave
Chino, CA 91710
Phone (626) 918-6544

147 W College St
Covina, CA 91723
Phone (626) 332-2860

315 N 3rd Ave
Ste 302
Covina, CA 91723
Phone (626) 332-1194

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

315 N 3rd Ave
Ste 102
Covina, CA 91723
Phone (626) 261-4048

412 W Carroll Ave
Ste 107
Glendora, CA 91741
Phone (626) 852-0411

541 S Pasadena Ave
#101
Glendora, CA 91741
Phone (626) 610-1850

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

412 W Carroll Ave
Ste 108
Glendora, CA 91741
Phone (626) 852-0411

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

1125 Via Verde
San Dimas, CA 91773
Phone (909) 592-8170

1135 S Sunset Ave
Ste 401
West Covina, CA 91790
Phone (626) 732-8390

1050 Lakes Dr
Ste 100
West Covina, CA 91790
Phone (626) 918-6655

1250 S Sunset Ave
Ste 100
West Covina, CA 91790
Phone (626) 338-1800

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

1115 S Sunset Ave
West Covina, CA 91790
Phone (626) 814-2434

1135 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 918-6655

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1659317733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 LAKES DR",
            "address_2": "SUITE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902924",
            "telephone_number": "626-918-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "91790",
            "telephone_number": "626-918-6655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Via Verde",
            "address_purpose": "LOCATION",
            "city": "San Dimas",
            "state": "CA",
            "postal_code": "917734400",
            "country_code": "US",
            "telephone_number": "909-599-6126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "VIC",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A45453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.