SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC. (NPI# 1164637922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164637922 |
| Entity Type | Organization |
| Organization Name | SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC. |
| Other Organization Name | SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC. |
| Practice Address |
1405 Montgomery Dr Santa Rosa CA 95405-4557 |
| Practice Telephone | 7075461922 |
| Practice Fax Number | 7075461897 |
| Mailing Telephone | 7075461922 |
| Mailing Fax Number | 7075461897 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2019-04-29 |
| Authorized Official Name | ROBERTA A ORTLINGHAUS (BUSINESS OFFICE SUPERVISOR) |
| Authorized Official Telephone | 7075461922 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Santa Rosa Orthopaedic Medical Group, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831753813 | Santa Rosa Orthopaedic Medical Group, Inc. | Orthopaedic Surgery | 167 Lynch Creek Way, Petaluma, CA 94954-2343 | 2019-04-25 |
| 1437713500 | Santa Rosa Orthopaedic Medical Group, Inc. | Orthopaedic Surgery | 34 Mark West Springs Rd Ste 300, Santa Rosa, CA 95403-1783 | 2019-04-24 |
| 1518907336 | Santa Rosa Orthopaedic Medical Group, Inc. | Physical Medicine & Rehabilitation | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2006-06-08 |
| Street Address |
1405 MONTGOMERY DR |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750365102 | Michael James Mcdermott | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2005-11-30 |
| 1487118105 | Rodney Gerrit Dekleuver | Physician Assistant | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2019-01-27 |
| 1083010813 | Nadine Raymond | Occupational Therapist | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2014-11-05 |
| 1043471279 | Christian Nabil Athanassious | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2008-06-20 |
| 1720272313 | Neema Pourtaheri | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-08-28 |
| 1114126869 | Dominic J Mintalucci | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-07-13 |
| 1891997227 | Jennifer Henshaw-lefever | Occupational Therapist | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-06-05 |
| 1477765931 | Robert J Smith | Physician Assistant | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-05-04 |
| 1588876049 | Patricia K Hall | Physical Therapist | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-05-04 |
| 1821200395 | Christopher T Krug | Physical Therapist | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154736882 | James H Bauer | Orthopaedic Surgery | 4700 Woodview Dr, Santa Rosa, CA 95405-8746 | 2014-06-20 |
| 1265550743 | Alexander Paul Iezza | Orthopaedic Surgery | 208 Concourse Blvd Ste 1, Santa Rosa, CA 95403-8210 | 2007-03-26 |
| 1831265073 | William Horn Ramsey IIi | Orthopaedic Surgery | 2200 County Center Dr, Suite E, Santa Rosa, CA 95403-3000 | 2006-11-28 |
| 1538199518 | Eric S Schmidt, Md, Inc | Orthopaedic Surgery | 525 Doyle Park Dr, Suite 101, Santa Rosa, CA 95405-4516 | 2006-07-04 |
| 1538117353 | Paul S Treuhaft | Orthopaedic Surgery | 903 Wildwood Trl, Santa Rosa, CA 95409-4423 | 2006-05-04 |
| 1265416077 | Steven Allen Smith | Orthopaedic Surgery | 121 Sotoyome Street, Santa Rosa, CA 95405-4823 | 2005-12-05 |
| 1750365102 | Michael James Mcdermott | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2005-11-30 |
| 1043471279 | Christian Nabil Athanassious | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2008-06-20 |
| 1023205713 | Northern California Medical Assoc | Orthopaedic Surgery | 1111 Sonoma Ave, Ste 202, Santa Rosa, CA 95405-4813 | 2007-09-27 |
| 1720272313 | Neema Pourtaheri | Orthopaedic Surgery | 1405 Montgomery Dr, Santa Rosa, CA 95405-4557 | 2007-08-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.