Stanislaus Orthopaedic and Sports Medicine Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

STANISLAUS ORTHOPAEDIC AND SPORTS MEDICINE CLINIC

Practice address

609 E Orangeburg Ave
Modesto, CA 95350-5580

Phone

(209) 572-3224

Fax

(209) 572-4528

NPI assigned

Mar 13, 2007

Last updated

Aug 24, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Casey, M.D.NPI 1811909716

Title

Senior Partner

Phone

(209) 572-3224

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 26

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.

• John Joseph Casey, M.D.

  • Specialist
  • Modesto, CA
  • NPI 1811909716
  Medicare reassignment Care Compare group Authorized official
• Jesua Israel Law, D.O.

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1487090049
  Medicare reassignment Care Compare group NPD
• Joel Louis Frazier, MD

  • Orthopaedic Hand Surgery Physician
  • Modesto, CA
  • NPI 1366448466
  Medicare reassignment Care Compare group
• Anne Marie Fultz, OTR

  • Hand Occupational Therapist
  • Modesto, CA
  • NPI 1154446771
  Medicare reassignment Care Compare group
• Hailey K. Himes

  • Physical Therapist
  • Modesto, CA
  • NPI 1972720357
  Medicare reassignment Care Compare group
• Jonathan Matthew Pettegrew, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Modesto, CA
  • NPI 1053552745
  Medicare reassignment Care Compare group
• William Louis Pistel, D.O.

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1518979418
  Medicare reassignment Care Compare group
• Marc A Trzeciak, D. O.

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1033111026
  Medicare reassignment Care Compare group
• Michael Wolterbeek, DPM

  • Podiatrist
  • Modesto, CA
  • NPI 1497767396
  Medicare reassignment Care Compare group
• Jonathan Canton, MOT

  • Orthopedic Physical Therapist
  • Modesto, CA
  • NPI 1417455791
  Medicare reassignment NPD
• Angelica Buenrostro, PA-C

  • Medical Physician Assistant
  • Modesto, CA
  • NPI 1720052418
  Medicare reassignment
• William J Holmes, MD

  • Orthopaedic Surgery Physician
  • Modesto, CA
  • NPI 1629026141
  Medicare reassignment

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1669505160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505580",
            "telephone_number": "209-572-3224",
            "fax_number": "209-572-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E ORANGEBURG AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505580",
            "telephone_number": "209-572-3224",
            "fax_number": "209-572-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANISLAUS ORTHOPAEDIC AND SPORTS MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "209-572-3224",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislaus County Office of Education
• Stanislaus County, Dept of Aging and Veterans Services, MSSP
• Stanislaus Family Medicine Residency
• Stanislaus Health and Wellness Inc (209 Urgent Care)
• Stanislaus Optometric Center, Inc.
• Stanislaus Orthopaedics Sports Medicine Clinic
• Stanislaus Subacute Rehab LLC
• Stanislaus Surgical Hospital LLC
• Stanislaus Union School District
• Stanislaus Vision Associates Optometric Group Inc

• Specialist in Modesto, CA
• Providers in Modesto, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.