Organization Active NPI

Pacific Orthopaedic Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Arcadia, CA
National Provider Identifier
1891109567
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PACIFIC ORTHOPAEDIC MEDICAL GROUP, INC
Practice address
289 West Huntington Drive
Suite 206
Arcadia, CA 91007
Phone
(626) 282-1600
NPI assigned
Jun 20, 2014
Last updated
Jun 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Ms. Sarah Du
Title
Accounts Receivable Manager
Phone
(626) 656-1324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

289 West Huntington Drive
Suite 206
Arcadia, CA 91007

Mailing address

PO Box 25706
Pasadena, CA 91185-5706
Phone (626) 282-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625001148 CA Part B Supplier - Clinic/Group Practice 6204812670 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: City of Industry, CA; Alhambra, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pacific Orthopaedic Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

911 S Garfield Ave
Alhambra, CA 91801
Phone (626) 282-8411

289 W Huntington Dr
Ste 206
Arcadia, CA 91007
Phone (626) 282-1600

56 E Duarte Rd
Arcadia, CA 91006
Phone (626) 447-4888

18605 Gale Ave
Ste 168
City of Industry, CA 91748
Phone (626) 282-0255

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1891109567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25706",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911855706",
            "telephone_number": "626-282-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 WEST HUNTINGTON DRIVE",
            "address_2": "SUITE 206",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "91007",
            "telephone_number": "626-282-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ORTHOPAEDIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "DU",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "626-656-1324",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.