Active NPI
East Coast Spine Joint and Sports Medicine
- Physical Medicine & Rehabilitation Physician
- Hoboken, NJ
National Provider Identifier
1194904730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 25MA07808900
- Legal business name
- EAST COAST SPINE JOINT AND SPORTS MEDICINE
- Practice address
- 720 Monroe Street
Suite C-208
Hoboken, NJ 07030-5000 - Phone
- (201) 533-9200
- NPI assigned
- Oct 31, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alexander J Visco, M.D.
- Title
- Medical Director
- Phone
- (201) 533-9200
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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00542700 | NJ | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 25MA07808900 | NJ | Primary |
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 25MA07808900 | NJ | |
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
720 Monroe Street
Suite C-208
Hoboken, NJ 07030-5000
Mailing address
720 Monroe Street
Suite C-208
Hoboken, NJ 07030-5000
Phone (201) 533-9200
Other practice location 1
764 Broadway
Bayonne, NJ 07002-3948
Phone (201) 533-9200
Other practice location 2
121 Newark Ave
Jersey City, NJ 07302-5872
Phone (201) 533-9200
Other names 1
- The Spine and Sports Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071115000011 | NJ | Part B Supplier - Clinic/Group Practice | 2365530938 |
Receives reassigned benefits from 22 practitioners Practice locations: Jersey City, NJ; Hoboken, NJ; Bayonne, NJ |
National Provider Directory
National Provider DirectoryLocations
764 Broadway
Bayonne, NJ 07002
Phone (917) 232-2458
720 Monroe St
Ste E304
Hoboken, NJ 07030
720 Monroe St
Ste C208
Hoboken, NJ 07030
Phone 20153392001005
121 Newark Ave
Jersey City, NJ 07302
Phone (201) 677-2232
26 Journal Sq
Ste 402
Jersey City, NJ 07306
Practitioners & affiliated clinicians
Practitioners 28
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Hoboken, NJ
- NPI 1205968310
NJ, Physical Medicine & Rehabilitation
-
- Chiropractor
- Bayonne, NJ
- NPI 1952315129
-
- Pain Medicine (Anesthesiology) Physician
- Westfield, NJ
- NPI 1255570925
Multi-Specialty, NJ
-
- Chiropractor
- Jersey City, NJ
- NPI 1508683608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663545600000",
"number": "1194904730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 MONROE STREET",
"address_2": "SUITE C-208",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070305000",
"telephone_number": "201-533-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 MONROE STREET",
"address_2": "SUITE C-208",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070305000",
"telephone_number": "201-533-9200"
}
],
"practiceLocations": [
{
"address_1": "764 Broadway",
"address_purpose": "LOCATION",
"city": "Bayonne",
"state": "NJ",
"postal_code": "070023948",
"country_code": "US",
"telephone_number": "201-533-9200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "121 Newark Ave",
"address_purpose": "LOCATION",
"city": "Jersey City",
"state": "NJ",
"postal_code": "073025872",
"country_code": "US",
"telephone_number": "201-533-9200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "EAST COAST SPINE JOINT AND SPORTS MEDICINE",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-31",
"last_updated": "2022-09-19",
"certification_date": "2022-02-16",
"status": "A",
"authorized_official_last_name": "VISCO",
"authorized_official_first_name": "ALEXANDER",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "201-533-9200",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00542700",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "NJ",
"license": "25MA07808900",
"primary": true
},
{
"code": "2081S0010X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "NJ",
"license": "25MA07808900",
"primary": false
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Spine and Sports Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hoboken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.