Organization Active NPI

Ronald Glousman MD Medical Corporation

  • Orthopaedic Surgery Physician
  • Santa Ana, CA
National Provider Identifier
1922421171
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
RONALD GLOUSMAN MD MEDICAL CORPORATION
Practice address
999 N Tustin Ave
Ste 114
Santa Ana, CA 92705-3528
Phone
(714) 508-1981
Fax
(866) 807-7466
NPI assigned
Jan 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Ronald Eric Glousman, MDNPI 1104897289
Title
President
Phone
(714) 313-1454

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X

Addresses

Primary practice location

999 N Tustin Ave
Ste 114
Santa Ana, CA 92705-3528

Mailing address

PO Box 570627
Tarzana, CA 91357-0627
Phone (310) 659-9116

Other identifiers 1

IdentifierTypeStateIssuer
1104897289OtherCAINDIVIDUAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170404001065 CA Part B Supplier - Clinic/Group Practice 5991929176 Receives reassigned benefits from 1 practitioner
Practice locations: Encino, CA; Santa Ana, CA

National Provider Directory

National Provider Directory

Locations

4510 Brockton Ave
Ste 385
Riverside, CA 92501
Phone (714) 508-1981

3579 Arlington Ave
Ste 300
Riverside, CA 92506
Phone (626) 529-5003

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1922421171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 570627",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913570627",
            "telephone_number": "310-659-9116",
            "fax_number": "866-807-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N TUSTIN AVE",
            "address_2": "STE 114",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053528",
            "telephone_number": "714-508-1981",
            "fax_number": "866-807-7466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD GLOUSMAN MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "GLOUSMAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-313-1454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1104897289",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.