MERCED ORTHOPAEDIC MEDICAL GROUP, INC (NPI# 1326046012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326046012 |
| Entity Type | Organization |
| Organization Name | MERCED ORTHOPAEDIC MEDICAL GROUP, INC |
| Practice Address |
123 W North Bear Creek Dr Merced CA 95348-3420 |
| Mailing Address |
123 W North Bear Creek Drive Merced CA 95348 |
| Practice Telephone | 2097228161 |
| Mailing Telephone | 2097228161 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-03-27 |
| Authorized Official Name | DR. SAMUEL B TACKE (MD) |
| Authorized Official Telephone | 2097228161 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | ========= | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZZ48011Z | 05 |
| Street Address |
123 W NORTH BEAR CREEK DR |
| City | MERCED |
| State | CA |
| Zip Code | 95348-3420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699081141 | Sablan Orthopedics, Inc. | Orthopaedic Surgery | 123 W North Bear Creek Dr, Merced, CA 95348-3420 | 2010-08-22 |
| 1962618462 | Mario Kekona Sablan | Orthopaedic Surgery | 123 W North Bear Creek Dr, Merced, CA 95348-3420 | 2007-05-14 |
| 1568553824 | Mark W Via | Orthopaedic Surgery | 123 W North Bear Creek Dr, Merced, CA 95348-3420 | 2006-09-28 |
| 1477644730 | Matt Sidener | Physician Assistant | 123 W North Bear Creek Dr, Merced, CA 95348-3420 | 2006-09-28 |
| 1235236993 | Samuel B Tacke | Orthopaedic Surgery | 123 W North Bear Creek Dr, Merced, CA 95348-3420 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063031649 | Sydney Towle | Counselor | 3360 N Hwy 59 Suite K, Merced, CA 95348 | 2020-04-13 |
| 1972147544 | Aaliyah Belt | Behavior Technician | 2808 Park Ave, Suite A, Merced, CA 95348 | 2019-11-06 |
| 1922566025 | Michelle Chao Lee | Case Manager/Care Coordinator | 3360 North Hwy 59 Suite K, Merced, CA 95348 | 2019-03-07 |
| 1760952246 | Noemi Diaz | Counselor | 3360 North Hwy.59 Suite K, Merced, CA 95348 | 2018-11-28 |
| 1518451632 | Kenneth Tiea Pay | Pharmacist | 767 Ironstone Dr, Merced, CA 95348 | 2018-06-21 |
| 1295223444 | Andraya Diane Plascencia | Behavior Technician | 335 M St, Merced, CA 95348 | 2018-04-24 |
| 1801398839 | Elisabet Pulido | Case Manager/Care Coordinator | 3360 N State Hwy 59, K, Merced, CA 95348 | 2018-03-06 |
| 1184126674 | Carolina Rosales | Behavior Technician | 3335 M St., Merced, CA 95348 | 2018-03-01 |
| 1659897957 | Melody Vega | Social Worker | 3195 M Street, Merced, CA 95348 | 2017-08-17 |
| 1942739305 | Salvador Tinoco Jaramillo | Marriage & Family Therapist | 3360 N Highway 59 Suite K, Merced, CA 95348 | 2017-06-08 |
| Find all providers in zip 95348 | ||||
| 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 |
|---|---|---|---|---|
| 1497983498 | Naseem Neon Beauchman | Orthopaedic Surgery | 3329 G St Ste A, Merced, CA 95340 | 2009-06-29 |
| 1184829442 | Gabriel Garcia-diaz | Orthopaedic Surgery | 3180 Collins Dr Ste A, Merced, CA 95348-3156 | 2007-06-18 |
| 1063531291 | Abner Michael Ward | Orthopaedic Surgery | 240 E 13th St Ste C, Merced, CA 95341 | 2007-03-28 |
| 1093817215 | Stephen F. Corcoran | Orthopaedic Surgery | 3349 'g' St., Suite F, Merced, CA 95340 | 2006-09-01 |
| 1659384881 | Mark Thomas Hellner | Orthopaedic Surgery | 900 W Olive Ave, Suite A, Merced, CA 95348-2429 | 2006-08-15 |
| 1548206808 | John Sanford Holmes | Orthopaedic Surgery | 850 W Olive Ave, Suite A, Merced, CA 95348-2427 | 2006-06-22 |
| 1053655191 | Orthospine Advance Health, Inc | Orthopaedic Surgery | 3180 Collins Dr, Suite A, Merced, CA 95348-3161 | 2012-11-15 |
| 1699081141 | Sablan Orthopedics, Inc. | Orthopaedic Surgery | 123 W North Bear Creek Dr, Merced, CA 95348-3420 | 2010-08-22 |
| 1134442544 | Mark T Hellner Md Inc | Orthopaedic Surgery | 900 W Olive Ave, Suite A, Merced, CA 95348-2401 | 2010-03-12 |
| 1184814220 | Lynn Walter Cooman Jr. | Orthopaedic Surgery | 301 E 13th St, Merced, CA 95341-6211 | 2007-07-25 |
| Find all providers in MERCED | ||||
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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.