{
  "npi": "1679656649",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "M.D.",
    "authorized_official_first_name": "ROBERT",
    "authorized_official_last_name": "FAY",
    "authorized_official_middle_name": "M.",
    "authorized_official_name_prefix": "--",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "7604857402",
    "authorized_official_title_or_position": "President",
    "enumeration_date": "2006-10-23",
    "last_updated": "2023-03-07",
    "organization_name": "ADVANCED ORTHOPEDIC SPECIALISTS MEDICAL CORPORATION",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 839",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "LA QUINTA",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "760-771-4183",
      "postal_code": "922470839",
      "state": "CA",
      "telephone_number": "760-485-7402"
    },
    {
      "address_1": "720 N NORMA ST",
      "address_2": "SUITE A AND B",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "RIDGECREST",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "760-771-4183",
      "postal_code": "935553553",
      "state": "CA",
      "telephone_number": "760-485-7402"
    }
  ],
  "taxonomies": [
    {
      "code": "204C00000X",
      "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "204D00000X",
      "desc": "Neuromusculoskeletal Medicine & OMM",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XS0106X",
      "desc": "Orthopaedic Surgery, Hand Surgery",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XS0114X",
      "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XS0117X",
      "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XX0004X",
      "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XX0005X",
      "desc": "Orthopaedic Surgery, Sports Medicine",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207XX0801X",
      "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "208200000X",
      "desc": "Plastic Surgery",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "2082S0099X",
      "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "2082S0105X",
      "desc": "Plastic Surgery, Surgery of the Hand",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "2086S0102X",
      "desc": "Surgery, Surgical Critical Care",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "2086S0127X",
      "desc": "Surgery, Trauma Surgery",
      "license": "A68720",
      "primary": false,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "207X00000X",
      "desc": "Orthopaedic Surgery",
      "license": "A68720",
      "primary": true,
      "state": "CA",
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)",
    "certifying_board": "American Board of Orthopaedic Surgery (ABOS)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "02",
        "medicare_type": "Physician/General Surgery"
      },
      {
        "medicare_code": "20",
        "medicare_type": "Physician/Orthopedic Surgery"
      }
    ]
  }
}