NPIMap

Organization Active NPI

Orange Orthopedic Medica GP, Inc. the Providence BLDG

  • Orthopaedic Surgery Physician
  • Orange, CA
National Provider Identifier
1679560585
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORANGE ORTHOPEDIC MEDICA GP, INC. THE PROVIDENCE BLDG
Practice address
1310 W Stewart Dr Ste 410
Orange, CA 92868-3855
Phone
(714) 538-8549
Fax
(714) 538-1547
NPI assigned
Oct 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Authorized official

Name
Ms. Stacy Thorne
Title
Billing Specialist
Phone
(714) 538-8549

Specialties & licenses 1

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

Addresses

Primary practice location

1310 W Stewart Dr Ste 410
Orange, CA 92868-3855

Mailing address

1310 W Stewart Dr Ste 410
Orange, CA 92868-3855
Phone (714) 538-8549

Other identifiers 1

IdentifierTypeStateIssuer
GR0003520MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050429000552 CA Part B Supplier - Clinic/Group Practice 2961441852 Receives reassigned benefits from 14 practitioners
Practice locations: Orange, CA
O20100930002350 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2961441852 Practice locations: Orange, CA

National Provider Directory

National Provider Directory

Locations

2501 E Chapman Ave
#407
Orange, CA 92869

1140 W La Veta Ave
Fl 3
Orange, CA 92868

1310 W Stewart Dr
Ste 510
Orange, CA 92868
Phone (714) 538-8549

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1679560585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683855",
            "telephone_number": "714-538-8549",
            "fax_number": "714-538-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683855",
            "telephone_number": "714-538-8549",
            "fax_number": "714-538-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE ORTHOPEDIC MEDICA GP, INC. THE PROVIDENCE BLDG",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "THORNE",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "714-538-8549",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0003520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.