NPIMap

Organization Active NPI

Sports and Spine Orthopaedics

  • Orthopaedic Surgery Physician
  • Torrance, CA
National Provider Identifier
1811936743
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A62201 Issued in CA
Legal business name
SPORTS AND SPINE ORTHOPAEDICS
Practice address
23456 Hawthorne Blvd
Suite 200 Building 5
Torrance, CA 90505-4716
Phone
(310) 375-8700
NPI assigned
Jun 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
Mrs. Nora Mies
Title
Patient Account Rep
Phone
(310) 375-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X A62201 CA Primary

Addresses

Primary practice location

23456 Hawthorne Blvd
Suite 200 Building 5
Torrance, CA 90505-4716

Mailing address

23456 Hawthorne Blvd
Suite 200 Building 5
Torrance, CA 90505-4716
Phone (310) 375-8700

Other identifiers 2

IdentifierTypeStateIssuer
601860000OtherCADOL
6332760001OtherCANATIONAL SUPPLIER CLEARINGHOUSE

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100728000322 CA Part B Supplier - Clinic/Group Practice 8224028378 Receives reassigned benefits from 25 practitioners
Practice locations: Torrance, CA
O20100930046794 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8224028378 Practice locations: Torrance, CA

National Provider Directory

National Provider Directory

Locations

1421 W MacArthur Blvd
Ste E
Santa Ana, CA 92704
Phone (617) 894-1718

23456 Hawthorne Blvd
Ste 110
Torrance, CA 90505
Phone (310) 375-8700

23456 Hawthorne Blvd
Ste 205
Torrance, CA 90505
Phone (310) 791-4040

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 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1811936743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD",
            "address_2": "SUITE 200 BUILDING 5",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-375-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD",
            "address_2": "SUITE 200 BUILDING 5",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-375-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND SPINE ORTHOPAEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "MIES",
        "authorized_official_first_name": "NORA",
        "authorized_official_title_or_position": "PATIENT ACCOUNT REP",
        "authorized_official_telephone_number": "310-375-8700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A62201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "601860000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL SUPPLIER CLEARINGHOUSE",
            "identifier": "6332760001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.