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SPINE AND SPORTS SPECIALITIES MEDICAL GROUP
NPI 1013306174
Orthopaedic Surgery in Orange, CA

Active since January 13, 2015
1120 W. LA VETA AVENUE, SUITE 300, ORANGE, CA 92868(714) 598-1745(714) 941-9539 Get Directions Write a Review

NPPES record last updated: November 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 20, 2021, May 8, 2019, Apr 23, 2019 (3 updates tracked since 2019).

About Spine And Sports Specialities Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPINE AND SPORTS SPECIALITIES MEDICAL GROUP (NPI 1013306174) is a healthcare organization registered as an orthopaedic surgery in Orange, California and active in the NPI registry since January 2015. The organization maintains a secondary practice location in Orange and lists Corinne Walker, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1013306174
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameSPINE AND SPORTS SPECIALITIES MEDICAL GROUP
Location Address1120 W. LA VETA AVENUE, SUITE 300Orange, CA 92868-4233
Mailing Address1120 W La Veta Ave Ste 300Orange, CA 92868-4246 · (714) 598-1745 · Fax (714) 941-9539
Phone(714) 598-1745
Fax(714) 941-9539
Organization SubpartNo
Authorized OfficialCorinne WalkerChief Operating Officer · (714) 598-1745
Enumeration DateJanuary 13, 2015
Last NPPES UpdateNovember 1, 20243 updates tracked since enumeration
NPPES CertifiedNovember 1, 2024
✔ NPI 1013306174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
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.
Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X
Also ListedOrthopaedic Surgery · Hand SurgeryTaxonomy 207XS0106X
Also ListedOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryTaxonomy 207XS0114X
Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X
Also ListedOrthopaedic Surgery · Foot and Ankle SurgeryTaxonomy 207XX0004X
Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X
Also ListedPain Medicine · Interventional Pain MedicineTaxonomy 208VP0014X
Also ListedClinic/Center · RadiologyTaxonomy 261QR0200X
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X
1120 W. LA VETA AVENUE, Orange, CA 92868
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Secondary Practice Location 1

Location 11140 W La Veta Ave Ste 605Orange, CA 92868-4219 · Phone (714) 598-1745 ext. 1038 · Fax (714) 941-9539

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spine And Sports Specialities Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

13

Medicare enrollment records show 13 clinicians reassign Medicare billing to Spine And Sports Specialities Medical Group, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 12 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 6

Orthopedic Surgery8
Anesthesiology1
Nurse Practitioner1
Pain Management1
Physical Medicine and Rehabilitation1
Sports Medicine1

Clinicians, nearest first (13)

Christian Awah, MD
Orthopedic Surgery
NPI 1013470707
1120 W LA VETA AVE STE 300
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Stacey Bederman, M.D.
Orthopedic Surgery
NPI 1316190085
1120 W. LA VETA AVENUE SUITE 300 SPINE AND SPORTS SPECIALTIES MEDICAL GROUP
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Gregory Carlson, M.D.
Orthopedic Surgery
NPI 1215924329
1120 W. LA VETA AVENUE SUITE 300
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Eric Chang, M.D.
Physical Medicine and Rehabilitation
NPI 1407062920
1120 W LA VETA AVE SUITE 300
Orange, CA 92868
(657) 210-4096
✔ PECOS✔ Accepts MedicareSame address
Andrew Germanovich, D.O., M.S.
Anesthesiology
NPI 1043479835
1120 W. LA VETA AVENUE SUITE 300
Orange, CA 92868
(657) 210-4096
✔ PECOS✔ Accepts MedicareSame address
Navid Ghalambor, M.D.
Orthopedic Surgery
NPI 1619920667
1120 W LA VETA AVE STE 300
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Michael Gillman, M.D.
Orthopedic Surgery
NPI 1275536633
1120 W. LA VETA AVENUE SUITE 300
Orange, CA 92868
(657) 210-4096
✔ PECOS✔ Accepts MedicareSame address
Duke Hasson, M.D
Orthopedic Surgery
NPI 1831489939
1120 W LA VETA AVE STE 300
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Brandon Lucas, M.D.
Orthopedic Surgery
NPI 1437546496
1120 W LA VETA AVE STE 300
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Steve Mora, M.D.
Orthopedic Surgery
NPI 1780747287
1120 W. LA VETA AVENUE SUITE 300
Orange, CA 92868
(657) 210-4096
✔ PECOS✔ Accepts MedicareSame address
Young Eun Song
Nurse Practitioner
NPI 1700358116
1120 W LA VETA AVE STE 300
Orange, CA 92868
(714) 598-1745
✔ PECOS✔ Accepts MedicareSame address
Nirav Amin, M.D.
Sports Medicine
NPI 1477714665
1325 N ROSE DR STE 210
Placentia, CA 92870
(909) 596-4346
✔ PECOS✔ Accepts Medicare7.5 mi
Tracy Jackson, MD
Pain Management
NPI 1154436590
2960 CAMINO DIABLO STE 105
Walnut Creek, CA 94597
(800) 892-2695
✔ PECOS✔ Accepts Medicare353 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spine And Sports Specialities Medical Group's NPI number?

The NPI number for Spine And Sports Specialities Medical Group is 1013306174. It was assigned to this organization in the NPPES registry on January 13, 2015.

Where is Spine And Sports Specialities Medical Group located?

Spine And Sports Specialities Medical Group is located at 1120 W. La Veta Avenue Suite 300, Orange, CA 92868. The listed phone number is (714) 598-1745.

What is Spine And Sports Specialities Medical Group's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Spine And Sports Specialities Medical Group enrolled in Medicare?

Yes. Spine And Sports Specialities Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Spine And Sports Specialities Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians in 6 Medicare specialties reassign their Medicare billing to Spine And Sports Specialities Medical Group. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Orthopedic Surgery (8), Anesthesiology (1) and Nurse Practitioner (1). Of these, 11 practice at this address and 12 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Spine And Sports Specialities Medical Group was last updated on November 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.