NPIMap

Organization Active NPI

Advanced Orthopedic and Spine Care SC

  • Orthopaedic Surgery Physician
  • Tinley Park, IL
National Provider Identifier
1013269547
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ADVANCED ORTHOPEDIC AND SPINE CARE SC
Practice address
16255 S. Harlem Ave
Tinley Park, IL 60477
Phone
(708) 599-5000
Fax
(708) 599-0801
NPI assigned
Oct 8, 2012
Last updated
Apr 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Troy, MDNPI 1790737021
Title
Director
Phone
(708) 599-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

16255 S. Harlem Ave
Tinley Park, IL 60477

Mailing address

PO Box 825
Bedford Park, IL 60499-0825
Phone (708) 599-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121119000345 IL Part B Supplier - Clinic/Group Practice 4789835836 Receives reassigned benefits from 9 practitioners
Practice locations: Hazel Crest, IL; Kankakee, IL; Mokena, IL; Oak Lawn, IL; Palos Heights, IL; Tinley Park, IL
O20130314000116 IL DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Sports MedicineDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 4789835836 Practice locations: Oak Lawn, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2339377Advanced Orthopedic & Spine Care, S C16255 S Harlem Ave, Tinley Park, IL 60477Certificate of waiverMar 1, 2028

National Provider Directory

National Provider Directory

Locations

6735 W 95th St
Oak Lawn, IL 60453
Phone (708) 598-0717

16255 Harlem Ave
Tinley Park, IL 60477
Phone (708) 599-5000

Interoperability endpoints

  • Direct secure messaging: a.mietus@direct.advancedorthospine.com
  • Direct secure messaging: d.troy@direct.advancedorthospine.com
  • Direct secure messaging: j.perezsanz@direct.advancedorthospine.com
  • Direct secure messaging: j.watson@direct.advancedorthospine.com
  • Direct secure messaging: k.oliversen@direct.advancedorthospine.com
  • Direct secure messaging: p.danielsky@direct.advancedorthospine.com
  • Direct secure messaging: t.schub@direct.advancedorthospine.com

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1013269547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825",
            "city": "BEDFORD PARK",
            "state": "IL",
            "postal_code": "604990825",
            "telephone_number": "708-599-5000",
            "fax_number": "708-599-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16255 S. HARLEM AVE",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "60477",
            "telephone_number": "708-599-5000",
            "fax_number": "708-599-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORTHOPEDIC AND SPINE CARE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "TROY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-599-5000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.