NPIMap

Organization Active NPI

North Jersey Sports Medicine & Orthopedic Center, LLC

  • Specialist
  • Randolph, NJ
National Provider Identifier
1013342609
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MB06971100 Issued in NJ
Legal business name
NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CENTER, LLC
Practice address
711 Route 10 E Ste 100
Randolph, NJ 07869-2030
Phone
(908) 684-3005
Fax
(908) 684-3301
NPI assigned
Sep 13, 2013
Organization subpart
Yes
Parent organization
NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Authorized official

Name
Dr. Robert A Defalco Jr., M.D.NPI 1174554471
Title
Owner
Phone
(908) 684-3005

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 25MB06971100 NJ Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 25MB06992500 NJ

Addresses

Primary practice location

711 Route 10 E Ste 100
Randolph, NJ 07869-2030

Mailing address

376 Lafayette Rd Ste 202
Sparta, NJ 07871-3560
Phone (908) 684-3005

Other names 1

  • The Orthopedic Institute of NJ Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150319000884 NJ DME Supplier - Physician - Orthopedic/Orthopedic Surgery 6709895733 Practice locations: Randolph, NJ

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
North Jersey SP Med Orthop7 organizations share this tax ID, including this one
Part of
North Jersey SP Med Orthop

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

711 Route 10 E
Ste 100
Randolph, NJ 07869

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1013342609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 LAFAYETTE RD STE 202",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713560",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ROUTE 10 E STE 100",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692030",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH JERSEY SPORTS MEDICINE & ORTHOPEDIC C",
        "enumeration_date": "2013-09-13",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "DEFALCO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-684-3005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB06971100",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB06992500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Orthopedic Institute of NJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.