SPINE & SPORTS SURGICAL CENTER, LLC.
NPI 1932598760
Clinic/Center - Ambulatory Surgical in Orange, CA

NPI Status: Active since January 16, 2015

Contact Information

1120 W LA VETA AVE
300
ORANGE, CA
ZIP 92868
Phone: (714) 598-1745
Fax: (714) 941-9539

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 05D2094177
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 04-12-2027

About SPINE & SPORTS SURGICAL CENTER, LLC.

This page provides the complete NPI Profile along with additional information for Spine & Sports Surgical Center, Llc., a provider established in Orange, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1932598760 assigned on January 2015. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Gregory D Carlson Md (President)

NPI
1932598760
Provider Name
SPINE & SPORTS SURGICAL CENTER, LLC.
Entity Type
Organization
Location Address
1120 W LA VETA AVE 300 ORANGE, CA 92868
Location Phone
(714) 598-1745
Location Fax
(714) 941-9539
Mailing Address
1120 W LA VETA AVE # 330 ORANGE, CA 92868
Mailing Phone
(714) 598-1745
Mailing Fax
(714) 941-9539
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-16-2015
Last Update Date
04-20-2021
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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

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GREGORY D CARLSON MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(714) 598-1745

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 129 times for 71 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 48 times for 28 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 169 times for 96 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 226 times for 70 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 140 times for 113 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 44 times for 40 patients

Injection of upper or middle spine facet joint using imaging guidance, single level

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

This service was performed 141 times for 43 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 89 times for 47 patients

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
05D2094177
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
April 13, 2025
Certificate Expiration Date
April 12, 2027
Laboratory Director
GREGORY D. CARLSON, MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Spine & Sports Surgical Center, Llc. 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.

Reviews for SPINE & SPORTS SURGICAL CENTER, LLC.

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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.
1932598760
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
296210916712
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 6 + 2 + 1 + 0 + 9 + 1 + 6 + 7 + 1 + 2 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1932598760 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 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1215930219 GREGORY SCOTT BUCHERT M.D.
Individual
Pediatrics1120 W LA VETA AVE FL 2
ORANGE, CA 92868
(714) 246-8688
1356348973DR. KRISTIN R GERICKE PHARM.D.
Individual
Pharmacist1120 W LA VETA AVE CALOPTIMA
ORANGE, CA 92868
(714) 246-8460
1194724583 MARYAM GHOLIZADEH M.D.
Individual
Surgery (Pediatric Surgery)1120 W LA VETA AVE STE. 100
ORANGE, CA 92868
(714) 289-4704
1699777664CHILDREN'S SURGICAL ASSOCIATES, A MEDICAL CORPORATION
Organization
Surgery (Pediatric Surgery)1120 W LA VETA AVE STE. 100
ORANGE, CA 92868
(714) 571-5000
1225184518 BRUCE R HOYLE M.D.
Individual
Family Medicine (Sports Medicine)1120 W LA VETA AVE STE 830
ORANGE, CA 92868
(714) 955-5960
1528106861 SHABNAM ERAGI PHARMD
Individual
Pharmacist1120 W LA VETA AVE
ORANGE, CA 92868
(714) 246-8724
1154466621DR. GERTRUDE SANDRA CARTER M.D.
Individual
Pediatrics1120 W LA VETA AVE 2ND FLOOR
ORANGE, CA 92868
(714) 347-3261
1104940717DR. SUSAN VIGIL PHARM.D.
Individual
Pharmacist1120 W LA VETA AVE 2ND FLOOR MAIL ROOM
ORANGE, CA 92868
(714) 347-3296
1194908293PEDIATRIC SURGICAL SPECIALISTS OF ORANGE COUNTY
Organization
Surgery (Pediatric Surgery)1120 W LA VETA AVE SUITE 100
ORANGE, CA 92868
(714) 361-4480
1689904187 SANG UN BAE PHARM. D.
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)1120 W LA VETA AVE
ORANGE, CA 92868
(714) 246-8471
1114329984DR. MICHELE AUDREY OCEN PH.D., BCBA
Individual
Psychologist (Clinical Child & Adolescent)1120 W LA VETA AVE SUITE 470
ORANGE, CA 92868
(202) 415-6308
1093102766CHILDREN'S HOSPITAL OF ORANGE COUNTY
Organization
Psychologist (Clinical Child & Adolescent)1120 W LA VETA AVE SUITE 470
ORANGE, CA 92868
(714) 509-8481
1407062920DR. ERIC YAO CHANG M.D.
Individual
Physical Medicine & Rehabilitation (Pain Medicine)1120 W LA VETA AVE SUITE 300
ORANGE, CA 92868
(657) 210-4096
1437533114 JOSHUA MILLER PA-C
Individual
Physician Assistant1120 W LA VETA AVE SUITE 300
ORANGE, CA 92868
(657) 210-4096
1841299328 ALI REZA KAVIANIAN M.D.
Individual
Surgery (Pediatric Surgery)1120 W LA VETA AVE STE. 100
ORANGE, CA 92868
(714) 289-4704
1104284116ERIC T HEYER MD PC
Organization
Specialist1120 W LA VETA AVE SUITE 300
ORANGE, CA 92868
(714) 598-1745
1386191328DR. ARIE ZAKARYAN PH.D.
Individual
Psychologist (Clinical Child & Adolescent)1120 W LA VETA AVE STE 470
ORANGE, CA 92868
(714) 509-8235
1659693349 STEPHANIE ERIKA BAZURTO
Individual
Community Health Worker1120 W LA VETA AVE
ORANGE, CA 92868
(888) 770-2462
1396227997 DHRUVI CHAUHAN
Individual
Community Health Worker1120 W LA VETA AVE
ORANGE, CA 92868
(714) 997-3000
1407338007 PATRICK PAIZ BS
Individual
Community Health Worker1120 W LA VETA AVE
ORANGE, CA 92868
(888) 770-2462

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1932598760, enumerated in the NPI registry as an "organization" on January 16, 2015

The provider is located at 1120 W La Veta Ave 300 Orange, Ca 92868 and the phone number is (714) 598-1745

This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical

The most common procedures or services performed by this practitioner are: Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint, Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint, Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level, Injection of lower or sacral spine facet joint using imaging guidance, single level, Injection of substance into lower spine canal using imaging guidance, Injection of substance into middle or upper spine canal using imaging guidance, Injection of upper or middle spine facet joint using imaging guidance, single level and Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography.

The provider's CLIA number is 05D2094177 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 January 16, 2015. 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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