Orthopaedic Regenerative Medicine, LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

ORTHOPAEDIC REGENERATIVE MEDICINE, LLC

Practice address

4765 S Lakeshore Dr
Tempe, AZ 85282-7197

Phone

(602) 429-0404

NPI assigned

Apr 29, 2020

Organization subpart

No

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

Authorized official

Name

Angelo Mattalino, MD

Title

Owner

Phone

(602) 429-0404

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1164043204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N SCOTTSDALE RD # 9-844",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4765 S LAKESHORE DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827197",
            "telephone_number": "602-429-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC REGENERATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-29",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "MATTALINO",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-429-0404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vianei Oros Zamudio
• Adia Orozco, RBT
• Gisselle Orozco
• Jaclyn R Orozco, D.D.S.
• Michael J Orris, D.O.
• Orthopedic Therapy and Wellness, PLLC
• Samantha Ortiz
• Sarah L Ortlund, STUDENT LCPC
• Leah Beth Osborn, MAS-MFT, LAMFT
• Husameldin Osman

• All providers in Tempe, AZ
• Sports Medicine (Orthopaedic Surgery) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.