Individual provider Active NPI

Donald V Stevenson, M.D.

  • Orthopaedic Surgery Physician
  • Inglewood, CA
National Provider Identifier
1770584047
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G48296 Issued in CA
Practice address
575 E. Hardy St
Suite 105
Inglewood, CA 90301-4040
Phone
(310) 674-1211
Fax
(310) 674-8668
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G48296 CA Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X G48296 CA

Addresses

Primary practice location

575 E. Hardy St
Suite 105
Inglewood, CA 90301-4040

Mailing address

575 E. Hardy St
Suite 105
Inglewood, CA 90301-4040
Phone (310) 674-1211

Other identifiers 1

IdentifierTypeStateIssuer
00G482960MedicaidCA

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
I20101014000377 CA Practitioner - Orthopedic Surgery 5193842045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Southern California Keck School of Medicine, 1981
Medicare assignment
May accept Medicare assignment
Group practices
Stevenson Orthopaedic Medical ClinicGroup PAC ID 0648480277, 2 clinicians

Practice addresses (Care Compare)

575 E Hardy St
Suite 109
Inglewood, CA 90301-4039
Phone (310) 674-1211

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G48296CAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stevenson Orthopaedic Medical Clinic Orthopaedic Surgery CurrentSince Jul 14, 2010 Accepting new patients
RJ Physical Therapy Group Inc PastSince Jan 26, 2021 Accepting new patients

Locations

575 E Hardy St
Ste 105
Inglewood, CA 90301
Phone (310) 412-0100

575 E Hardy St
Ste 109
Inglewood, CA 90301
Phone (310) 419-8585

Interoperability endpoints

  • Direct secure messaging: dstevenson@stevensonorthopaedicmedicalclini.adaptamed.direct-ci.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1770584047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E. HARDY ST",
            "address_2": "SUITE 105",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014040",
            "telephone_number": "310-674-1211",
            "fax_number": "310-674-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E. HARDY ST",
            "address_2": "SUITE 105",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014040",
            "telephone_number": "310-674-1211",
            "fax_number": "310-674-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "DONALD",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G48296",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G48296",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G482960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.