SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
NPI 1891450920
Orthopaedic Surgery in Petaluma, CA
NPI Status: Active since November 03, 2021
Contact Information
169 LYNCH CREEK WAY
PETALUMA, CA
ZIP 94954
Phone: (707) 546-1922
- Organization
- Orthopaedic Surgery
- CLIA Number: 05D1015301
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 11-11-2025
About SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
This page provides the complete NPI Profile along with additional information for Santa Rosa Orthopaedic Medical Group, Inc., a provider established in Petaluma, California operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1891450920 assigned on November 2021. The practitioner's primary taxonomy code is 207X00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Santa Rosa Orthopaedic Medical Group, Inc. operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Alicia Brophy (Practice Manager)
- NPI
- 1891450920
- Provider Name
- SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
- Entity Type
- Organization
- Location Address
- 169 LYNCH CREEK WAY PETALUMA, CA 94954
- Location Phone
- (707) 546-1922
- Mailing Address
- 1405 MONTGOMERY DR SANTA ROSA, CA 95405
- Mailing Phone
- (707) 546-1922
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-03-2021
- Last Update Date
- 07-14-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207XS0106X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 2 | 207XX0004X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 3 | 207XX0005X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 4 | 207XX0801X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 5 | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
| 6 | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
| 7 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D1015301
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- November 12, 2023
- Certificate Expiration Date
- November 11, 2025
- Laboratory Director
- WANHUA YANG
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Santa Rosa Orthopaedic Medical Group, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 9 | 1 | 4 | 5 | 0 | 9 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 18 | 1 | 8 | 5 | 0 | 9 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 8 + 1 + 8 + 5 + 0 + 9 + 4 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1891450920 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1962599704 | RICK SUSICK MS PT ATC Individual | Physical Therapist | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 763-0115 |
| 1306933676 | MRS. DEBRA MAY SOJKA P.T. Individual | Physical Therapist | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 763-0115 |
| 1245310549 | KEVIN THOMAS WHITE MPT Individual | Physical Therapist (Orthopedic) | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 763-0115 |
| 1376627885 | MR. ROBERT L. CLARK PT Individual | Physical Therapist | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 763-0115 |
| 1306933163 | PETALUMA PHYSICAL THERAPY ASSOCIATES INC Organization | Physical Therapist | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 763-0115 |
| 1023071909 | MRS. JACQUELINE MICHELLE QUINN M.P.T. Individual | Physical Therapist | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 763-0115 |
| 1598473688 | RENA MARY RIBEIRO OTR/L Individual | Occupational Therapist | 169 LYNCH CREEK WAY PETALUMA, CA 94954 (707) 522-5405 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891450920, enumerated in the NPI registry as an "organization" on November 03, 2021
The provider is located at 169 Lynch Creek Way Petaluma, Ca 94954 and the phone number is (707) 546-1922
This medical organization specializes in Orthopaedic Surgery with taxonomy code 207X00000X
The provider's CLIA number is 05D1015301 for a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 03, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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