NPIMap

Organization Active NPI

Synergy Orthopedic Specialists, Inc.

  • Specialist
  • San Diego, CA
National Provider Identifier
1952998445
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SYNERGY ORTHOPEDIC SPECIALISTS, INC.
Practice address
3750 Convoy St Ste 201
San Diego, CA 92111-3770
Phone
(858) 278-8300
NPI assigned
Dec 30, 2020
Organization subpart
Yes
Parent organization
SYNERGY ORTHOPEDIC SPECIALISTS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Meghan Thomas
Title
Credentialing Specialist
Phone
(858) 412-6080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3750 Convoy St Ste 201
San Diego, CA 92111-3770

Mailing address

4445 Eastgate Mall Ste 105
San Diego, CA 92121-1979
Phone (858) 412-6080

Other names 1

  • Synergy Specialists Medical Group, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220419000986 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0941450498 Practice locations: San Diego, CA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Synergy Orthopedic Specialists Inc23 organizations share this tax ID, including this one
Part of
Synergy Orthopedic Specialists Inc

Other organizations with this tax ID 21

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

View all 21

Locations

4445 Eastgate Mall
Ste 105
San Diego, CA 92121
Phone (858) 357-9450

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1952998445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-412-6080",
            "fax_number": "858-412-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113770",
            "telephone_number": "858-278-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY ORTHOPEDIC SPECIALISTS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SYNERGY ORTHOPEDIC SPECIALISTS, INC.",
        "enumeration_date": "2020-12-30",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "858-412-6080"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Specialists Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Synergy Specialists Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.