NPIMap

Individual provider Active NPI

Travis Loidolt, DO

  • Orthopaedic Surgery of the Spine Physician
  • Roseville, CA
National Provider Identifier
1811254329
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
20A16495 Issued in CA
Practice address
584 N Sunrise Ave Ste 100
Roseville, CA 95661-2862
Phone
(916) 800-4685
Fax
(916) 512-3901
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X 20A16495 CA Primary

Addresses

Primary practice location

584 N Sunrise Ave Ste 100
Roseville, CA 95661-2862

Mailing address

2220 E Bidwell St
Folsom, CA 95630-3463
Phone (916) 800-4685

Other practice location 1

2220 E Bidwell St
Folsom, CA 95630-3463
Phone (916) 800-4685

Other identifiers 1

IdentifierTypeStateIssuer
20A16495OtherCACA MED LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161028000500 OK Practitioner - Emergency Medicine 7911285853 Reassigns benefits to 1 organization
I20190207000111 CA Practitioner - Orthopedic SurgeryPractitioner - Other (Physician) 7911285853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Travis Loidolt DO IncGroup PAC ID 4587991674, 4 clinicians

Practice addresses (Care Compare)

2220 E Bidwell St
Folsom, CA 95630-3463
Phone (916) 800-4685

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as individual
Quality
73.27
Promoting interoperability
100
Improvement activities
40
Cost
69.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion387
Laminectomy or laminotomy (partial removal of spine bones)116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A16495CAMDOrthopaedic Surgery of the Spine Physician
16495CAMDMassage Therapist
5405OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Emergency Services PC Multi-Specialty CurrentSince Sep 1, 2016 Accepting new patients
Sutter North Medical Foundation PastSince Nov 26, 2018 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter Regional Medical Foundation Multi-Specialty Past Accepting new patients

Locations

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

Interoperability endpoints

  • Direct secure messaging: tloidolt414829@hisp.ehr.sutterhealth.org
  • Direct secure messaging: travis.loidolt.1@19921.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1811254329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 E BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-800-4685",
            "fax_number": "916-512-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "584 N SUNRISE AVE STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612862",
            "telephone_number": "916-800-4685",
            "fax_number": "916-512-3901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2220 E Bidwell St",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303463",
            "country_code": "US",
            "telephone_number": "916-800-4685",
            "fax_number": "916-512-3901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOIDOLT",
        "first_name": "TRAVIS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "20A16495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MED LICENSE",
            "identifier": "20A16495",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.