ERIK C SPAYDE MD
NPI 1609818822
Orthopaedic Surgery in Thousand Oaks, CA


Quality Rating: 93.57 out of 100 score

NPI Status: Active since June 12, 2006

Contact Information

1001 NEWBURY RD
THOUSAND OAKS, CA
ZIP 91320
Phone: (805) 379-2322
Fax: (805) 379-6786

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  • Individual
  • Male
  • Years of Experience 26
  • Orthopaedic Surgery
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ERIK SPAYDE

This page provides the complete NPI Profile along with additional information for Erik Spayde, a provider established in Thousand Oaks, California with a medical specialization in Orthopaedic Surgery and more than 26 years of experience. He graduated from Harvard Medical School in 2000. The healthcare provider is registered in the NPI registry with number 1609818822 assigned on June 2006. The practitioner's primary taxonomy code is 207X00000X with license number A90130 (CA). The provider is registered as an individual and his NPI record was last updated April 2026.

NPI
1609818822
Provider Name
ERIK C SPAYDE MD
Gender
Male
Entity Type
Individual
Location Address
1001 NEWBURY RD THOUSAND OAKS, CA 91320
Location Phone
(805) 379-2322
Location Fax
(805) 379-6786
Mailing Address
1001 NEWBURY RD THOUSAND OAKS, CA 91320
Mailing Phone
(805) 379-2322
Mailing Fax
(805) 379-6786
Medical School Name
HARVARD MEDICAL SCHOOL
Graduation Year
2000
Is Sole Proprietor?
Yes
Enumeration Date
06-12-2006
Last Update Date
04-02-2026
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Location Map

Secondary Locations

  • 558 Saint Charles Dr Suite 200
    Thousand Oaks, CA 91360
    (805) 379-2322

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

Orthopaedic Surgery

Taxonomy Code
207X00000X
Type
Allopathic & Osteopathic Physicians
License No.
A90130
License State
CA
Taxonomy Description
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.

Medicare Participation & PECOS Enrollment Status

Erik Spayde is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Erik Spayde is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3779502174

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20051115000709

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE000N)

    Osteogenesis stimulator, electrical, non-invasive, spinal applications (HCPCS:E0748)

    1 DME suppliers used 84 Medicare Claims 84 Services Paid

Orthotic Devices

  • DME-Orthotic Devices (DF000N)

    Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar) (HCPCS:L0120)

    1 DME suppliers used 20 Medicare Claims 20 Services Paid

  • DME-Orthotic Devices (DF000N)

    Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf (HCPCS:L0174)

    1 DME suppliers used 22 Medicare Claims 22 Services Paid

  • DME-Orthotic Devices (DF007N)

    Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise (HCPCS:L0637)

    1 DME suppliers used 125 Medicare Claims 125 Services Paid

  • DME-Orthotic Devices (DF007N)

    Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf (HCPCS:L0650)

    1 DME suppliers used 21 Medicare Claims 21 Services Paid

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.

Complete ultrasound study of arm and leg arteries

This procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.

This service was performed 364 times for 182 patients

Electrocardiogram (ecg) 1 to 3 leads with review by physician

An Electrocardiogram (ECG) is a non-invasive test that records the electrical activity of your heart. It uses 1 to 3 leads (sensors) placed on your skin. A physician reviews the results to assess heart rate, rhythm, and detect any abnormalities.

This service was performed 154 times for 154 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 24 times for 24 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 1,910 times for 944 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 32 times for 30 patients

Exploration of spine fusion

Exploration of spine fusion is a procedure to examine a previously performed spinal fusion surgery. The process checks the success of the fusion or finds potential issues, such as hardware failure or non-union of the fused vertebrae. It's a diagnostic tool to ensure healing.

This service was performed 45 times for 39 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 17 times for 16 patients

Fusion of additional segment of spine

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

This service was performed 156 times for 79 patients

Fusion of lower spine bone through abdomen with partial removal of disc

This procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.

This service was performed 81 times for 81 patients

Fusion of pelvic joint using imaging guidance

This procedure involves joining or "fusing" the pelvic joint to alleviate pain or stabilize the area. It's performed under imaging guidance, which helps the doctor visualize the area and ensure precise placement of medical tools. This can improve recovery and outcome.

This service was performed 20 times for 20 patients

Fusion of spine bones through front of body with partial removal of disc, each additional disc

This procedure involves merging spine bones via the front of the body. A portion of each additional disc is removed to ease pressure and discomfort. This helps to stabilize the spine and improve mobility.

This service was performed 54 times for 42 patients

Fusion of spine in lower back

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

This service was performed 52 times for 50 patients

Fusion of spine in lower back with partial removal of spine bone and disc

This procedure, called lumbar spinal fusion, involves joining two or more vertebrae in your lower back. It includes a partial removal of a spine bone and disc to alleviate pain and improve stability. The goal is to reduce motion between vertebrae and prevent nerve irritation.

This service was performed 40 times for 40 patients

Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc

This procedure involves fusing together the bones in the upper spine to stabilize it. A disc is removed to ease pressure on the spinal cord or nerve. This helps reduce pain and improve mobility. This is a common treatment for certain spinal conditions.

This service was performed 19 times for 19 patients

Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, each additional disc

This is a surgical procedure where the upper spine bones are joined together after removing a disc. This helps to relieve pressure on the spinal cord or nerves. If more discs need to be removed, the same process is repeated for each additional disc.

This service was performed 22 times for 15 patients

Harvest of bone fragment for spine bone graft

A harvest of a bone fragment for a spine bone graft is a procedure where a small piece of bone is taken from another part of your body. This bone is then used to help repair or strengthen areas in your spine that may be damaged or weak.

This service was performed 109 times for 108 patients

Insertion of cage or mesh device in disc space during spine fusion

During spine fusion, a cage or mesh device may be inserted into the disc space. This device aids in stabilizing the spine and promoting bone growth for fusion. It's a common and safe procedure used to treat conditions like spinal stenosis or herniated discs.

This service was performed 67 times for 33 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

This service was performed 125 times for 80 patients

Laminectomy or laminotomy (partial removal of spine bones)

A laminectomy or laminotomy is a surgical procedure that involves removing part of the bone in your spine, specifically the lamina, to alleviate pressure on your spinal cord or nerves. This can help reduce pain and improve mobility if you're suffering from conditions like herniated discs or spinal stenosis.

This service was performed for 188 patients

Mri scan of arm joint without contrast

An MRI scan of the arm joint is a non-invasive imaging procedure that uses magnetic fields and radio waves to create detailed images of the structures within your arm joint. No contrast dye is used in this process. It helps to diagnose or monitor conditions like arthritis, injuries, or infections.

This service was performed 56 times for 51 patients

Mri scan of brain without contrast

An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.

This service was performed 19 times for 19 patients

Mri scan of leg joint without contrast

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

This service was performed 92 times for 79 patients

Mri scan of lower spinal canal without contrast

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

This service was performed 710 times for 643 patients

Mri scan of middle spinal canal without contrast

An MRI scan of the middle spinal canal without contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed images of your spine. This helps doctors identify any abnormalities or issues in your spinal canal. No dye is used in this procedure.

This service was performed 176 times for 156 patients

Mri scan of pelvis without contrast

An MRI scan of the pelvis without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed pictures of the lower part of your body. This helps doctors to identify any abnormalities or issues in that area.

This service was performed 56 times for 56 patients

Mri scan of upper spinal canal without contrast

An MRI scan of the upper spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your upper spine. This helps doctors identify issues such as injuries, infections or diseases. No dye is used.

This service was performed 223 times for 213 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 437 times for 437 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 11 times for 11 patients

Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back

This procedure involves partially removing a bone section in the lower back to relieve pressure on the spinal cord or nerves. It's performed during a spinal fusion, where bones in the lower back are joined to improve stability and reduce pain.

This service was performed 53 times for 21 patients

Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back

This procedure involves the partial removal of a bone segment in your lower back to relieve pressure on your spinal cord or nerves. It's usually done during a spinal fusion in the lower back, which helps to stabilize your spine by joining two or more vertebrae together.

This service was performed 22 times for 22 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 111 times for 106 patients

Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment

This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.

This service was performed 212 times for 108 patients

Placement of device to stabilize or reduce pressure in lower spine in 1 disc space

This procedure involves placing a device in your lower spine to help support it and reduce pressure. It targets a specific area, known as a disc space, to alleviate discomfort and improve spinal function.

This service was performed 23 times for 23 patients

Placement of stabilizing device to back of 1 spine bone in neck

This procedure involves positioning a stabilizing device onto a single spinal bone in the neck. The goal is to provide support and prevent movement that could cause discomfort or further injury. It's performed by trained specialists under anesthesia.

This service was performed 31 times for 30 patients

Placement of stabilizing device to back, 3-6 spine bone segments

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

This service was performed 71 times for 67 patients

Placement of stabilizing device to front, 2-3 spine bone segments

This procedure involves positioning a stabilizing device on the front of 2-3 segments of your spine. It's designed to provide support and stability to your spine, potentially alleviating discomfort and improving mobility.

This service was performed 20 times for 20 patients

Release of lower spinal cord and/or nerves, single segment

This procedure involves freeing the lower spinal cord or nerves from any compression in a single segment. It can alleviate pain or discomfort, improve mobility, and enhance overall quality of life. This is performed by a skilled surgeon under anesthesia.

This service was performed 118 times for 114 patients

Release of major arm or leg nerve

A release of a major arm or leg nerve is a surgical procedure aimed to alleviate pressure on a nerve that's compressed. It can help reduce pain, numbness, or weakness. The procedure involves making a small incision and carefully freeing the nerve.

This service was performed 27 times for 24 patients

Release of middle or lower spinal cord and/or nerves, single segment

This procedure involves relieving pressure on the middle or lower spinal cord or nerves. A single section of the spine is focused on. It can help reduce pain, improve mobility, and enhance overall quality of life.

This service was performed 34 times for 33 patients

Release of nerve using operating microscope

This procedure, called a microsurgical nerve release, involves using a special microscope to enhance precision while freeing a trapped nerve. It can help alleviate pain and improve nerve function. It's a safe and effective method often used for conditions like carpal tunnel syndrome.

This service was performed 157 times for 147 patients

Release of upper leg nerve

A release of the upper leg nerve is a surgical procedure aimed at relieving pressure on a nerve in your upper leg. This is done to reduce pain, numbness, or weakness you may be experiencing. The procedure involves making a small incision and gently moving tissues away from the nerve.

This service was performed 138 times for 132 patients

Removal of middle, lower, or sacral spine bone with release of spinal cord or nerves, transperitoneal or retroperitoneal approach, single segment

This procedure involves the surgical removal of a bone segment from the middle, lower, or sacral area of your spine. It's done to relieve pressure on the spinal cord or nerves. The approach can be transperitoneal (through the abdomen) or retroperitoneal (behind the abdomen).

This service was performed 16 times for 16 patients

Removal of segmental stabilizing device from back of spine

This procedure involves the removal of a device from the back of your spine that was previously placed to provide stability. It's typically done when the spine has healed or improved enough to function without additional support.

This service was performed 45 times for 42 patients

Removal of upper spine bone with release of spinal cord and/or nerves, anterior approach, single segment

This procedure involves removing a portion of bone from your upper spine through an anterior (front) approach to alleviate pressure on your spinal cord or nerves. It focuses on a single segment of the spine. This can help reduce pain and improve function.

This service was performed 19 times for 19 patients

Set-up and patient education for remote monitoring of therapy

Remote therapy monitoring involves using digital devices to track your health and treatment progress from home. You'll receive a device to record health data, like heart rate or blood sugar. This data is shared with your healthcare team, allowing them to adjust your treatment as needed.

This service was performed 29 times for 29 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 185 patients

Testing of autonomic (sympathetic and parasympathetic) nervous system function, at least 5 minutes of tilt

This procedure tests how your autonomic nervous system, which controls body functions like heart rate and blood pressure, responds to changes in body position. You'll be secured on a tilt table and monitored for at least 5 minutes as the table is tilted to simulate standing up.

This service was performed 181 times for 181 patients

Testing of autonomic (sympathetic) nervous system function

Testing of autonomic nervous system function assesses how well your body's automatic processes, like heart rate and blood pressure, are working. It involves various non-invasive tests like heart rate variability and sweat production tests.

This service was performed 168 times for 168 patients

Treatment of broken lower spine bone with placement of stabilizing device

This procedure involves fixing a broken bone in the lower spine. A stabilizing device is inserted to support the bone, promoting healing and reducing pain. The device helps to maintain proper spinal alignment and stability during your recovery period.

This service was performed 52 times for 45 patients

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance

This procedure treats a broken bone in the middle of your spine. A stabilizing device is placed to support the damaged area. Imaging guidance, like X-rays, is used to ensure precise placement of the device. This aids in your recovery and helps maintain spine stability.

This service was performed 66 times for 55 patients

Treatment of broken spine bone with stabilizing device, each additional segment

This procedure involves the treatment of a fractured spine bone. A stabilizing device is used to support and secure each additional affected segment of the spine. This helps in proper alignment and promotes healing, enhancing your comfort and mobility.

This service was performed 44 times for 33 patients

X-ray lower and sacral spine, minimum of 6 views

An X-ray of the lower and sacral spine involves capturing images of the bones in your lower back and tailbone area. It helps to identify issues like fractures, infections, or degenerative diseases. A minimum of 6 views ensures a comprehensive examination.

This service was performed 205 times for 205 patients

X-ray of lower and sacral spine, 2-3 views

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

This service was performed 771 times for 476 patients

X-ray of middle spine, 2 views

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

This service was performed 143 times for 116 patients

X-ray of shoulder, minimum of 2 views

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

This service was performed 16 times for 13 patients

X-ray of upper spine, 2-3 views

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

This service was performed 197 times for 143 patients

X-ray of upper spine, 6 or more views

An X-ray of the upper spine with 6 or more views involves capturing multiple images of your neck and upper back. This non-invasive procedure helps doctors visualize the bones and joints, aiding in diagnosing conditions such as arthritis, fractures, or spinal deformities.

This service was performed 53 times for 53 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $23.82 for a new patient copayment and $19.27 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 91320 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $95.28
  • Minimum New Patient Price $62.32
  • Maximum New Patient Price $185.36
  • Average New Patient Copayment $23.82
  • Minimum New Patient Copayment $15.58
  • Maximum New Patient Copayment $46.34

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $77.11
  • Minimum Established Patient Price $20.68
  • Maximum Established Patient Price $151.85
  • Average Established Patient Copayment $19.27
  • Minimum Established Patient Copayment $5.17
  • Maximum Established Patient Copayment $37.96

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 93.57, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 93.57 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 85.33

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1609818822, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
0
Doubled → 0
Pos 4
9
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
1
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
8
Unchanged
Pos 9
2
Doubled → 4
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 8 → 16 → 7 8 → 16 → 7 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 0 + 9 + 1 + 6 + 1 + 1 + 6 + 8 + 4 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1609818822.

Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

Clinic/Center (Ambulatory Surgical)
1001 NEWBURY RD, #102
NEWBURY PARK, CA 91320
Neurological Surgery
1001 NEWBURY RD
NEWBURY PARK, CA 91320
Neurological Surgery
1001 NEWBURY RD
NEWBURY PARK, CA 91320
Physical Medicine & Rehabilitation
1001 NEWBURY RD
THOUSAND OAKS, CA 91320
Neurological Surgery
1001 NEWBURY RD
NEWBURY PARK, CA 91320
Radiology (Body Imaging)
1001 NEWBURY RD, #100 HILLCREST MRI MEDICAL GROUP MEDICAL IMAGING MEDICA
NEWBURY PARK, CA 91320
Neurological Surgery
1001 NEWBURY RD, #100
THOUSAND OAKS, CA 91320
Pain Medicine (Pain Medicine)
1001 NEWBURY RD
NEWBURY PARK, CA 91320
Physical Medicine & Rehabilitation
1001 NEWBURY RD
NEWBURY PARK, CA 91320
Physical Therapist
1001 NEWBURY RD
THOUSAND OAKS, CA 91320
Physician Assistant
1001 NEWBURY RD
THOUSAND OAKS, CA 91320
Clinic/Center (Ambulatory Surgical)
1001 NEWBURY RD
THOUSAND OAKS, CA 91320
Physical Medicine & Rehabilitation
1001 NEWBURY RD
THOUSAND OAKS, CA 91320
Orthopaedic Surgery
1001 NEWBURY RD
THOUSAND OAKS, CA 91320

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609818822, enumerated as an "individual" on June 12, 2006.

The provider is located at 1001 NEWBURY RD THOUSAND OAKS, CA 91320 and the phone number is (805) 379-2322.

Orthopaedic Surgery with taxonomy code 207X00000X.