NPIMap

Organization Active NPI

Ridgeline Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Northridge, CA
National Provider Identifier
1972953230
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
RIDGELINE EMERGENCY PHYSICIANS MEDICAL GROUP, INC.
Practice address
18300 Roscoe Blvd
Northridge, CA 91325-4105
Phone
(330) 493-4443
Fax
(330) 493-8677
NPI assigned
Jun 17, 2016
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Steven P. Maron, M.D.NPI 1821026063
Title
President
Phone
(925) 225-5837

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

18300 Roscoe Blvd
Northridge, CA 91325-4105

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161228000227 CA Part B Supplier - Clinic/Group Practice 0345521613 Receives reassigned benefits from 186 practitioners
Practice locations: Glendale, CA; Northridge, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 186

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.

View all 186

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1972953230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "330-493-4443",
            "fax_number": "330-493-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGELINE EMERGENCY PHYSICIANS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-225-5837",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.