Provider Demographics
NPI:1912978131
Name:ORTHOPAEDIC ASSOCIATES, INC
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-892-1440
Mailing Address - Street 1:24723 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2526
Mailing Address - Country:US
Mailing Address - Phone:440-892-1440
Mailing Address - Fax:440-892-4709
Practice Address - Street 1:24723 DETROIT RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2526
Practice Address - Country:US
Practice Address - Phone:440-892-1440
Practice Address - Fax:440-892-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000326930OtherANTHEM GROUP NUMBER OT
OH000000024938OtherANTHEM OAI GROUP NUMBER
OH000000326929OtherANTHEM PT GROUP NUMBER
OH0429898Medicaid
OH=========19OtherMMO OT GROUP NUMBER
OH=========17OtherMMO PT GROUP NUMBER
OH=========19OtherMMO OT GROUP NUMBER
OH0385370006Medicare NSC
OH0385370001Medicare NSC
OHCM0288Medicare PIN
OH000000326930OtherANTHEM GROUP NUMBER OT
OH0429898Medicaid
OH0385370007Medicare NSC