SOUTHERN CALIFORNIA SPINE AND SPORT MEDICAL ASSOCIATES, INC
SOUTHERN CALIFORNIA SPINE AND SPORT MEDICAL ASSOCIATES, INC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1902800543, based in Newport Beach, CA. The organization lists 4 taxonomy classifications, with Pain Medicine (Anesthesiology) Physician recorded as primary.
Getting there
The practice address on file is 1401 AVOCADO AVE STE 709, Newport Beach, CA 92660. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| G53385 | CA | Pain Medicine (Anesthesiology) Physician primary |
| Q34724 | CA | Medical Physician Assistant |
| PA65976 | CA | Medical Physician Assistant |
This provider holds licence G53385 issued in CA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 7810896768
Enrolled in Medicare 2 times, across 1 state:
| State | Enrollment ID | Provider type |
|---|---|---|
| California | O20040108000733 | Part B Supplier - Clinic/group Practice |
| California | O20111005000032 | Dme Supplier - Physician - General Surgery |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. There are 2 separate enrolment records. Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Pain Medicine covers
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. NUCC Health Care Provider Taxonomy, code 207LP2900X
All registered taxonomy codes
This provider registers 6 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207LP2900X | Pain Medicine (Anesthesiology) Physician Pain Medicine | G53385 | CA | primary |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician Pain Medicine | — | — | |
| 363A00000X | Physician Assistant | — | — | |
| 363AM0700X | Medical Physician Assistant Medical | Q34724 | CA | |
| 363AM0700X | Medical Physician Assistant Medical | PA65976 | CA | |
| 363AS0400X | Surgical Physician Assistant Surgical | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1902800543 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jun 10, 2005 |
| Last updated | Apr 26, 2023 |
| Status | Active |
| Practice address |
1401 AVOCADO AVE STE 709 Newport Beach, CA 92660 (949) 644-5800 Fax (949) 999-5813 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 9 | 0 | 2 | 8 | 0 | 0 | 5 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 9 | 0 | 2 | 7 | 0 | 0 | 5 | 8 |
Sum = 57 · next multiple of 10 = 60 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.