NPIMap

Organization Active NPI

Western Sierra Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Lake Arrowhead, CA
National Provider Identifier
1881995272
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
WESTERN SIERRA EMERGENCY PHYSICIANS MEDICAL GROUP INC
Practice address
29100 Hospital Road
Lake Arrowhead, CA 92352-9706
Phone
(855) 687-0618
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Authorized official

Name
Steven P. Maron, M.D.NPI 1821026063
Title
President
Phone
(855) 687-0618

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

29100 Hospital Road
Lake Arrowhead, CA 92352-9706

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (855) 687-0618

Other identifiers 1

IdentifierTypeStateIssuer
1881995272MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110318000559 CA Part B Supplier - Clinic/Group Practice 6709069396 Receives reassigned benefits from 33 practitioners
Practice locations: Lake Arrowhead, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1881995272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "855-687-0618",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29100 HOSPITAL ROAD",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "923529706",
            "telephone_number": "855-687-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN SIERRA EMERGENCY PHYSICIANS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-687-0618",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881995272",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Arrowhead, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.