NPIMap

Organization Active NPI

Orthopedic Specialists of North America, PLLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Tan Valley, AZ
National Provider Identifier
1679937262
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC
Practice address
40601 N Gantzel Rd Ste 103
San Tan Valley, AZ 85140-7036
Phone
(602) 648-5444
Fax
(602) 772-3801
NPI assigned
Apr 8, 2016
Organization subpart
Yes
Parent organization
ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Daleina Bulger
Title
Credentialing Manager
Phone
(602) 385-2115

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 44763 AZ
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

40601 N Gantzel Rd Ste 103
San Tan Valley, AZ 85140-7036

Mailing address

PO Box 80217
Phoenix, AZ 85060-0217
Phone (602) 385-2115

Other names 1

  • OrthoArizona Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Osna PLLC48 organizations share this tax ID, including this one
Part of
Osna PLLC

Other organizations with this tax ID 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1679937262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80217",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850600217",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40601 N GANTZEL RD STE 103",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407036",
            "telephone_number": "602-648-5444",
            "fax_number": "602-772-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOPEDIC SPECIALISTS OF NORTH AMERICA, PLLC",
        "enumeration_date": "2016-04-08",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "BULGER",
        "authorized_official_first_name": "DALEINA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "602-385-2115"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "44763",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoArizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.