Organization Active NPI

Northwest Orthopaedic Surgery

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Diego, CA
National Provider Identifier
1669947800
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
NORTHWEST ORTHOPAEDIC SURGERY
Practice address
8929 University Center LN Ste 205
San Diego, CA 92122-1008
Phone
(858) 703-6964
Fax
(858) 800-2518
NPI assigned
Oct 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Authorized official

Name
John Charles Austin, MDNPI 1518997378
Title
President
Phone
(858) 703-6964

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

8929 University Center LN Ste 205
San Diego, CA 92122-1008

Mailing address

8929 University Center LN Ste 205
San Diego, CA 92122-1008
Phone (858) 703-6964

Other practice location 1

8901 Activity Rd
Suite 205
San Diego, CA 92126
Phone (858) 356-9673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190110003151 CA Part B Supplier - Clinic/Group Practice 9739425869 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1669947800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8929 UNIVERSITY CENTER LN STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221008",
            "telephone_number": "858-703-6964",
            "fax_number": "858-800-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8929 UNIVERSITY CENTER LN STE 205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221008",
            "telephone_number": "858-703-6964",
            "fax_number": "858-800-2518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Activity Rd",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92126",
            "country_code": "US",
            "telephone_number": "858-356-9673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHWEST ORTHOPAEDIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-703-6964",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.