Individual provider Active NPI

Stephen A Dada, M.D.

  • Surgery Physician
  • Wildomar, CA
National Provider Identifier
1710040605
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A86832 Issued in CA
Practice address
36320 Inland Valley Dr.
Suite 101a
Wildomar, CA 92595-7512
Phone
(951) 698-3000
Fax
(951) 698-7700
NPI assigned
Dec 19, 2006
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A86832 CA Primary

Addresses

Primary practice location

36320 Inland Valley Dr.
Suite 101a
Wildomar, CA 92595-7512

Mailing address

36320 Inland Valley Dr.
Suite 101a
Wildomar, CA 92595-7512
Phone (951) 698-3000

Other identifiers 2

IdentifierTypeStateIssuer
ET544AOtherCAMEDICARE PTAN
1710040605MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070306000332 CA Practitioner - General Surgery 9931202306 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northridge Trauma Surgeons Inc a Medical CorporationGroup PAC ID 2567828825, 13 clinicians
Western Acute Care Surgeons IncGroup PAC ID 0143659862, 5 clinicians
Inland Valley Trauma and Acute Care Surgery Apc IncGroup PAC ID 9830444751, 11 clinicians
Murrieta Valley Surgery Associates Medical Group Inc ApcGroup PAC ID 6002136926, 16 clinicians

Practice addresses (Care Compare)

18300 Roscoe Blvd
Northridge, CA 91325-4105
Phone (818) 998-8591

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 327-3288

36320 Inland Valley Dr
Suite 101
Wildomar, CA 92595-7512
Phone (951) 698-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northridge Trauma Surgeons Inc a Medical Corporation Neurological Surgery CurrentSince Apr 25, 2023 Accepting new patients
Inland Valley Trauma and Acute Care Surgery Apc Inc Surgery CurrentSince Jun 1, 2018 Accepting new patients
Western Acute Care Surgeons Inc Surgery CurrentSince Aug 16, 2024 Accepting new patients
Trinity Medical Multi-Specialty Group Inc. CurrentSince Feb 27, 2020 Accepting new patients
Murrieta Valley Surgery Associates Medical Group, Inc, Apc Surgery CurrentSince Aug 1, 2023 Accepting new patients
Trinity Anesthesia Group Inc CurrentSince Sep 1, 2021 Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Regents of the Univ of Ca Surgery Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
First Surgery Center, Inc. PastSince Mar 1, 2020 Accepting new patients
Temecula Valley Hospital Inc Past Accepting new patients
Menifee Valley Medical Center Past Accepting new patients
West Gastroenterology Medical Group Past Accepting new patients

Locations

3853 W Stetson Ave
Ste 105
Hemet, CA 92545

18250 Roscoe Blvd
Ste 335
Northridge, CA 91325
Phone (818) 700-7900

18300 Roscoe Blvd
Northridge, CA 91325
Phone (818) 885-5331

9227 Reseda Blvd
Northridge, CA 91324
Phone (818) 631-1064

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

399 E Highland Ave
Ste 320
Sn Bernrdno, CA 92404
Phone (909) 327-3288

401 E Highland Ave
Ste 351
Sn Bernrdno, CA 92404
Phone (909) 475-8611

967 Kendall Dr
Ste A306
Sn Bernrdno, CA 92407

31537 Rancho Pueblo Rd
Ste 202
Temecula, CA 92592
Phone (951) 698-3000

31625 De Portola Rd
Ste 101
Temecula, CA 92592
Phone (951) 501-4200

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

36320 Inland Valley Dr
Ste 101
Wildomar, CA 92595
Phone (951) 600-3811

36320 Inland Valley Dr
Ste 101A
Wildomar, CA 92595
Phone 9516983000 ext. 304

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: sdada181885@direct.llu.edu

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1710040605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR.",
            "address_2": "SUITE 101A",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-698-3000",
            "fax_number": "951-698-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR.",
            "address_2": "SUITE 101A",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-698-3000",
            "fax_number": "951-698-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADA",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A86832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ET544A",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710040605",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.