NPIMap

Organization Active NPI

Orthopaedics Spine and Sports Medicine LLC

  • Orthopaedic Surgery of the Spine Physician
  • Bayonne, NJ
National Provider Identifier
1154030328
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC
Practice address
16 E 29TH St FL 2
Bayonne, NJ 07002-4603
Phone
(201) 971-7070
Fax
(201) 339-2109
NPI assigned
Nov 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Authorized official

Name
Nicole Tasso
Title
Credentialing Manager
Phone
(516) 795-3033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

16 E 29TH St FL 2
Bayonne, NJ 07002-4603

Mailing address

12 Unqua Rd
Massapequa, NY 11758-6727
Phone (516) 795-3033

Other practice location 1

54 S Dean St
Englewood, NJ 07631-3514
Phone (201) 971-7070

Other names 1

  • Total Orthopedics and Sports Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230328000754 NJ Part B Supplier - Clinic/Group Practice 0648318063 Receives reassigned benefits from 4 practitioners
Practice locations: Bayonne, NJ

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Orthopaedics Spine and Sports Medicine LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2510 Westchester Ave
Ste 100
Bronx, NY 10461
Phone (718) 684-4677

3059 Brighton 13th St
Brooklyn, NY 11235
Phone (718) 891-7100

10 Union Sq E
Ste Sp
New York, NY 10003

115 Eileen Way
Syosset, NY 11791
Phone (516) 622-9797

3728 Park Ave
Wantagh, NY 11793
Phone (516) 679-1207

Practitioners & affiliated clinicians

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1154030328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 UNQUA RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586727",
            "telephone_number": "516-795-3033",
            "fax_number": "516-654-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E 29TH ST FL 2",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024603",
            "telephone_number": "201-971-7070",
            "fax_number": "201-339-2109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 S Dean St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076313514",
            "country_code": "US",
            "telephone_number": "201-971-7070",
            "fax_number": "201-339-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHOPAEDICS SPINE AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "TASSO",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "516-795-3033"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Orthopedics and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.