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SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
NPI 1518907336
Orthopaedic Surgery in Santa Rosa, CA

Active since June 08, 2006
1701 4TH ST STE 200, SANTA ROSA, CA 95404(707) 546-1922(707) 528-1602 Get Directions Write a Review

NPPES record last updated: May 20, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 20, 2026, Jul 14, 2023, Apr 25, 2019 (3 updates tracked since 2019).

About Santa Rosa Orthopaedic Medical Group, Inc. NPPES

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

SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC. (NPI 1518907336) is a healthcare organization registered as an orthopaedic surgery in Santa Rosa, California and active in the NPI registry since June 2006. The organization lists Evangeline Vlacos, Contracting Credentialing Associate, as its authorized official.

NPPES Registry Identity

NPI1518907336
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameSANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
Location Address1701 4TH ST STE 200Santa Rosa, CA 95404-3661
Mailing Address1701 4th St Ste 200Santa Rosa, CA 95404-3661 · (707) 546-1922 · Fax (707) 528-1602
Phone(707) 546-1922
Fax(707) 528-1602
Organization SubpartNo
Authorized OfficialEvangeline VlacosContracting Credentialing Associate · (510) 387-2193
Enumeration DateJune 8, 2006
Last NPPES UpdateMay 20, 20263 updates tracked since enumeration
NPPES CertifiedMay 20, 2026
✔ NPI 1518907336 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ 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 ListedOrthopaedic Surgery · Hand SurgeryTaxonomy 207XS0106X
Also ListedOrthopaedic Surgery · Foot and Ankle SurgeryTaxonomy 207XX0004X
Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X
Also ListedOrthopaedic Surgery · Orthopaedic TraumaTaxonomy 207XX0801X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedOccupational Therapist · HandTaxonomy 225XH1200X
1701 4TH ST STE 200, Santa Rosa, CA 95404
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Other Identifiers 4

MedicaidGR0012520CA
OtherZZZ92332ZCA · Blue Shield Grp # 1405
Other1518907336Npi
Other379618500CA · Us Dept Of Labor (owcp)

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)

Santa Rosa Orthopaedic Medical Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Santa Rosa Orthopaedic Medical Group, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Thomas Axelrad, M.D.
Orthopedic Surgery
NPI 1326229204
1701 4TH ST STE 200
Santa Rosa, CA 95404
(707) 546-1922
✔ PECOS✔ Accepts MedicareSame address
Christian Athanassious, M.D.
Orthopedic Surgery
NPI 1043471279
1405 MONTGOMERY DR
Santa Rosa, CA 95405
(707) 546-1922
✔ PECOS✔ Accepts Medicare0.4 mi
Dominic Mintalucci, M.D.
Orthopedic Surgery
NPI 1114126869
1405 MONTGOMERY DR
Santa Rosa, CA 95405
(707) 546-1922
✔ PECOS✔ Accepts Medicare0.4 mi
Gary Stein, M.D.
Orthopedic Surgery
NPI 1952344525
1405 MONTGOMERY DR
Santa Rosa, CA 95405
(707) 546-1922
✔ PECOS✔ Accepts Medicare0.4 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 Santa Rosa Orthopaedic Medical Group, Inc.'s NPI number?

The NPI number for Santa Rosa Orthopaedic Medical Group, Inc. is 1518907336. It was assigned to this organization in the NPPES registry on June 8, 2006.

Where is Santa Rosa Orthopaedic Medical Group, Inc. located?

Santa Rosa Orthopaedic Medical Group, Inc. is located at 1701 4th St Ste 200, Santa Rosa, CA 95404. The listed phone number is (707) 546-1922.

What is Santa Rosa Orthopaedic Medical Group, Inc.'s specialty?

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

Is Santa Rosa Orthopaedic Medical Group, Inc. enrolled in Medicare?

Yes. Santa Rosa Orthopaedic Medical Group, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Santa Rosa Orthopaedic Medical Group, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Orthopedic Surgery, reassign their Medicare billing to Santa Rosa Orthopaedic Medical Group, Inc.. 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. Of these, 1 practice at this address and 4 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 Santa Rosa Orthopaedic Medical Group, Inc. was last updated on May 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.