Bayside Orthopedics, LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

25MB069402 Issued in NJ

Legal business name

BAYSIDE ORTHOPEDICS, LLC

Practice address

780 Route 37 W Ste 330
Toms River, NJ 08755-5059

Phone

(732) 966-6317

Fax

(732) 998-8086

NPI assigned

May 23, 2012

Organization subpart

No

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

Authorized official

Name

Erik S Larsen I, D.O.NPI 1508841305

Title

Dr.

Phone

(732) 966-6317

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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

• Erik Scott Larsen, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Toms River, NJ
  • NPI 1508841305
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1053671024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 ROUTE 37 W STE 330",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555059",
            "telephone_number": "732-966-6317",
            "fax_number": "732-998-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ROUTE 37 W STE 330",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555059",
            "telephone_number": "732-966-6317",
            "fax_number": "732-998-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE ORTHOPEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "732-966-6317",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MB069402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.