NPIMap

Organization Active NPI

Synergy Orthopedic Specialists, Inc.

Doing business as Synergy Orthopedic Specialists Medical Group

  • Specialist
  • Chula Vista, CA
National Provider Identifier
1679952485
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SYNERGY ORTHOPEDIC SPECIALISTS, INC.
Doing business as
Synergy Orthopedic Specialists Medical Group
Practice address
955 Lane Ave
Suite 200
Chula Vista, CA 91914-4525
Phone
(619) 421-3400
Fax
(619) 421-3557
NPI assigned
May 26, 2015
Last updated
Dec 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SYNERGY ORTHOPEDIC SPECIALISTS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Dr. Tal S David, MDNPI 1629092473
Title
President
Phone
(858) 571-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

955 Lane Ave
Suite 200
Chula Vista, CA 91914-4525

Mailing address

4445 Eastgate Mall
Suite 105
San Diego, CA 92121-1979
Phone (858) 412-6080

Other names 1

  • Synergy Orthopedic Specialists Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160418000395 CA DME Supplier - Physician - General Practice 0941450498 Practice locations: Chula Vista, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Synergy Specialists Medical Group22 organizations share this tax ID, including this one
Part of
Synergy Specialists Medical Group

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1679952485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL",
            "address_2": "SUITE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-412-6080",
            "fax_number": "858-412-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 LANE AVE",
            "address_2": "SUITE 200",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144525",
            "telephone_number": "619-421-3400",
            "fax_number": "619-421-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY ORTHOPEDIC SPECIALISTS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SYNERGY ORTHOPEDIC SPECIALISTS, INC.",
        "enumeration_date": "2015-05-26",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "TAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-571-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Orthopedic Specialists Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

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