NPIMap

Organization Active NPI

Specialty Medical Group Central California - Dept of Orthopedics

  • Orthopaedic Surgery Physician
  • Madera, CA
National Provider Identifier
1972784353
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF ORTHOPEDICS
Practice address
9300 Valley Childrens PL
Fe10
Madera, CA 93636-8761
Phone
(559) 353-5941
Fax
(559) 353-5945
NPI assigned
Nov 14, 2007
Last updated
Jun 28, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Devonna M. Kaji, M.D.
Title
President / Medical Director
Phone
(559) 353-5700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X CA Primary
Pediatrics Physician 208000000X CA

Addresses

Primary practice location

9300 Valley Childrens PL
Fe10
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL
Fe10
Madera, CA 93636-8761
Phone (559) 353-5941

Other identifiers 2

IdentifierTypeStateIssuer
1013968296OtherCASMG GENERAL GROUP NPI NUMBER
GR007868NMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Specialty Medical Group Central California - Dept of Medicine29 organizations share this tax ID, including this one
Part of
Specialty Medical Group Central California - Dept of Medicine

Other organizations with this tax ID 28

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

View all 28

Locations

9300 Valley Childrens Pl
#10
Madera, CA 93636
Phone (559) 353-5941

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1972784353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "address_2": "FE10",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5941",
            "fax_number": "559-353-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "address_2": "FE10",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5941",
            "fax_number": "559-353-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF ORTHOPEDICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INC.",
        "enumeration_date": "2007-11-14",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "KAJI",
        "authorized_official_first_name": "DEVONNA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-353-5700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMG GENERAL GROUP NPI NUMBER",
            "identifier": "1013968296",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR007868N",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.