Roseville Orthopedic Group a Medical Corp

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ROSEVILLE ORTHOPEDIC GROUP A MEDICAL CORP

Practice address

151 N Sunrise Ave
Ste 1005
Roseville, CA 95661-2930

Phone

(916) 782-1217

Fax

(916) 782-7630

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Miss Deborah A Butler

Title

Administrator

Phone

(916) 782-1217

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Practitioners 9

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

• Michael Y Han, M.D.

  • Orthopaedic Surgery Physician
  • Sacramento, CA
  • NPI 1144365529
  Medicare reassignment Care Compare group NPD
• Kevin Paul Hansen, MD

  • Specialist
  • Roseville, CA
  • NPI 1689661225
  Medicare reassignment Care Compare group NPD
• Annie Lan Anh Nguyentat, DPM

  • Podiatrist
  • Mountain View, CA
  • NPI 1134486160
  Medicare reassignment Care Compare group NPD
• Skyler Ingemansson, PA-C

  • Medical Physician Assistant
  • Roseville, CA
  • NPI 1942548482
  Medicare reassignment Care Compare group
• James Eric Eaton, M.S.P.T.

  • Physical Therapist
  • Roseville, CA
  • NPI 1558457325
  Medicare reassignment NPD
• Jack Marcelino Lomba, PT

  • Physical Therapist
  • Elk Grove, CA
  • NPI 1013091453
  Medicare reassignment NPD
• Thomas Craig Merchant, MD

  • Specialist
  • Roseville, CA
  • NPI 1437146255
  Medicare reassignment
• Tyler G Smith, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Roseville, CA
  • NPI 1386650802
  Medicare reassignment
• Trent Austin Deakers, DPT

  • Physical Therapist
  • Ontario, CA
  • NPI 1558957654
  NPD

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1962459990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "STE 1005",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612924",
            "telephone_number": "916-782-1217",
            "fax_number": "916-782-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "address_2": "STE 1005",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612930",
            "telephone_number": "916-782-1217",
            "fax_number": "916-782-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE ORTHOPEDIC GROUP A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-782-1217",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "ZZZ71352Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roseville Heritage Partners, LP
• Roseville Joint Union High School District
• Roseville MD Inc.
• Roseville Optometry
• Roseville Optometry Associates
• Roseville Orthopedic Physical Therapy Professional Corporation
• Roseville Orthopedics Group a Medical Corp
• Roseville Pain Management, Inc
• Roseville Pediatric Medical Group, Inc
• Roseville Point Health & Wellness Center LLC

• Specialist in Roseville, CA
• Providers in Roseville, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; 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.