NPIMap

Organization Active NPI

Progressive Spine & Orthopaedics, LLC

Doing business as Glen Rock Spine & Rehab

  • Physical Medicine & Rehabilitation Physician
  • Glen Rock, NJ
National Provider Identifier
1013598150
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
PROGRESSIVE SPINE & ORTHOPAEDICS, LLC
Doing business as
Glen Rock Spine & Rehab
Practice address
208 Harristown Rd Lowr Level1
Glen Rock, NJ 07452-3308
Phone
(201) 425-1560
NPI assigned
Apr 20, 2021
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PROGRESSIVE SPINE & ORTHOPAEDICS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Dr. Joshua Seth RovnerNPI 1578765244
Title
President
Phone
(201) 227-1299

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

208 Harristown Rd Lowr Level1
Glen Rock, NJ 07452-3308

Mailing address

208 Harristown Rd Lowr Level1
Glen Rock, NJ 07452-3308
Phone (201) 425-1560

Other names 1

  • Glen Rock Spine & Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120209000199 NJ Part B Supplier - Clinic/Group Practice 2961669528 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Perth Amboy, NJ; Glen Rock, NJ

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Progressive Spine Ortho LL4 organizations share this tax ID, including this one
Part of
Progressive Spine Ortho LL

Other organizations with this tax ID 3

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

Locations

208 Harristown Rd
Lowr 1
Glen Rock, NJ 07452
Phone (201) 371-3932

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1013598150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HARRISTOWN RD LOWR LEVEL1",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523308",
            "telephone_number": "201-425-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 HARRISTOWN RD LOWR LEVEL1",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523308",
            "telephone_number": "201-425-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE SPINE & ORTHOPAEDICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROGRESSIVE SPINE & ORTHOPAEDICS, LLC",
        "enumeration_date": "2021-04-20",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "ROVNER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "SETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-227-1299",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Rock Spine & Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glen Rock Spine & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Rock, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.