Individual provider Active NPI

Pouriya Ghayoumi, MD

  • Orthopaedic Surgery of the Spine Physician
  • Murrieta, CA
National Provider Identifier
1932581295
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A148106 Issued in CA
Practice address
25395 Hancock Ave Ste 240250
Murrieta, CA 92562-9019
Phone
(951) 557-1600
Fax
(951) 557-1740
NPI assigned
Jun 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD61041166 WA
Orthopaedic Surgery of the Spine Physician 207XS0117X A148106 CA Primary

Addresses

Primary practice location

25395 Hancock Ave Ste 240250
Murrieta, CA 92562-9019

Mailing address

PO Box 8520
Redlands, CA 92375-1720

Other identifiers 1

IdentifierTypeStateIssuer
1932581295MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609003136 CA Practitioner - Other (Physician)Practitioner - Orthopedic Surgery 9234487984 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Undefined Physician Type (Specify)Also: Orthopedic Surgery
Education
University of California, San Francisco School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ersno Eromo, MD Inc.Group PAC ID 4789918442, 3 clinicians

Practice addresses (Care Compare)

1400 S Grand Ave
Suite 707
Los Angeles, CA 90015-2881
Phone (757) 876-1690

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
78.77
Promoting interoperability
92
Improvement activities
40
Cost
48

Merit-based Incentive Payment System (MIPS)

Final score
90.02 of 100Reported as group
Quality
69.82
Promoting interoperability
95
Improvement activities
40
Cost
67.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A148106CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. Orthopaedic Surgery CurrentSince Jun 1, 2021 Accepting new patients
Glendale Adventist Medical Center CurrentSince May 1, 2023 Accepting new patients
Glendale Adventist Medical Center CurrentSince May 1, 2023 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Orthopaedic Surgery CurrentSince Jun 1, 2021 Accepting new patients
Ersno Eromo, MD Inc CurrentSince Aug 15, 2024 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. Orthopaedic Surgery PastSince Aug 29, 2021 Accepting new patients

Locations

1500 E Chevy Chase Dr
Ste 201
Glendale, CA 91206
Phone (818) 863-4099

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

1400 S Grand Ave
Ste 707
Los Angeles, CA 90015
Phone (213) 839-1119

25395 Hancock Ave
Ste 250
Murrieta, CA 92562
Phone (951) 557-1600

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

18840 Ventura Blvd
Ste 207
Tarzana, CA 91356
Phone (818) 654-8100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pouriya.ghayoumi.1@26092.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1932581295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8520",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923751720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25395 HANCOCK AVE STE 240250",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629019",
            "telephone_number": "951-557-1600",
            "fax_number": "951-557-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAYOUMI",
        "first_name": "POURIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD61041166",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A148106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932581295",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.