Scott Michael Graham, M.D.
Individual provider Active NPI Sports Medicine (Orthopaedic Surgery) Physician · Laguna Woods, CA
NPI 1902809551 · NPPES record last updated Oct 16, 2023
Key facts
- NPI
- 1902809551
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
- License
- A61526 (CA)
- Practice address
- 24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116 - Phone
- (949) 586-3200
- Fax
- (949) 900-2136
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- University of Southern California Keck School of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Orthowest
Practice addresses (Care Compare)
24331 El Toro Rd
Suite 200
Laguna Woods, CA 92637-3116
Phone (949) 586-3200
Hospital & facility affiliations
- Memorialcare Saddleback Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 22 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 37 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101109000449 | CA | Practitioner - Orthopedic Surgery | 1153530811 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61526 | CA | MD | Pharmacist |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthowest | Orthopaedic Surgery | Current |
Accepting new patients |
| Orthowest | Orthopaedic Surgery | Current |
Accepting new patients |
| South County Orthopedic Specialists | Current |
Accepting new patients | |
| Specialty Surgical Center of Irvine LP | Past |
Accepting new patients | |
| Saddleback Memorial Medical Center | Past | Accepting new patients | |
| Mission Hospital Regional Medical Center | Past | Accepting new patients |
Locations
18785 Brookhurst St
Ste 100
Fountain Valley, CA 92708
Phone (714) 500-5056
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
22 Odyssey
Ste 205
Irvine, CA 92618
Phone (949) 870-3332
24331 El Toro Rd
Ste 200
Laguna Woods, CA 92637
Phone (949) 767-0800
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- sgrahammd15704@direct.memorialcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | A61526 | CA | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | A61526 | CA | Yes |
Addresses
Primary practice location
24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116
Mailing address
24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116
Phone (949) 586-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A615260G89 | Other | CA | CAL-OPTIMA |
| 00A615260 | Medicaid | CA | |
| RR2000 42895 | Other | CA | MEDICARE RAILROAD |
Other providers in Laguna Woods, CA
- Bruce Glover
- Evan Goldman
- Michael Mark Goldman
- Ruth L. Goldman
- David Jr Gonzalez
- Susan K Grenz
- Dimitri Gruer
- Hamarock Consultants Inc
- Kelly A Hanks
- Hanmaum Medical Center
All providers in Laguna Woods, CA · Sports Medicine (Orthopaedic Surgery) Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.