Organization Active NPI

Valley Orthopedic Associates Medical Group, Inc.

Doing business as Valley Orthopedic Associates

  • Orthopaedic Surgery Physician
  • San Dimas, CA
National Provider Identifier
1780779736
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
VALLEY ORTHOPEDIC ASSOCIATES MEDICAL GROUP, INC.
Doing business as
Valley Orthopedic Associates
Practice address
627 E Foothill Blvd
San Dimas, CA 91773-1208
Phone
(909) 599-0881
Fax
(909) 394-0701
NPI assigned
Oct 4, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Dr. Tony Sami Bouz, D.O.NPI 1124482609
Title
Owner/Physician
Phone
(909) 599-0881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

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

Addresses

Primary practice location

627 E Foothill Blvd
San Dimas, CA 91773-1208

Mailing address

627 E Foothill Blvd
San Dimas, CA 91773-1208
Phone (909) 599-0881

Other identifiers 1

IdentifierTypeStateIssuer
00A332620MedicaidCA

Other names 1

  • Valley Orthopedic Associates Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050126000689 CA Part B Supplier - Clinic/Group Practice 2961452032 Receives reassigned benefits from 4 practitioners
Practice locations: San Dimas, CA; Montclair, CA; Chino, CA
O20240814000701 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 2961452032 Practice locations: San Dimas, CA

National Provider Directory

National Provider Directory

Locations

627 E Foothill Blvd
San Dimas, CA 91773
Phone (909) 599-0881

1334 W Covina Blvd
Ste 105
San Dimas, CA 91773
Phone (909) 599-0881

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 5

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1780779736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 E FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731208",
            "telephone_number": "909-599-0881",
            "fax_number": "909-394-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 E FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731208",
            "telephone_number": "909-599-0881",
            "fax_number": "909-394-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY ORTHOPEDIC ASSOCIATES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "BOUZ",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "SAMI",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "909-599-0881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A332620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Orthopedic Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Orthopedic Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.