NPIMap

Organization Active NPI

East Coast Spine Joint and Sports Medicine

Doing business as The Spine and Sports Health Center

  • Physical Medicine & Rehabilitation Physician
  • Hoboken, NJ
National Provider Identifier
1194904730
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MA07808900 Issued in NJ
Legal business name
EAST COAST SPINE JOINT AND SPORTS MEDICINE
Doing business as
The Spine and Sports Health Center
Practice address
720 Monroe Street
Suite C-208
Hoboken, NJ 07030-5000
Phone
(201) 533-9200
NPI assigned
Oct 31, 2007
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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.NPI 1205968310
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)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00542700 NJ
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 25MA07808900 NJ Primary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

11 W 25th St
Bayonne, NJ 07002
Phone (201) 243-9291

764 Broadway
Bayonne, NJ 07002
Phone (917) 232-2458

720 Monroe St
Ste C208
Hoboken, NJ 07030
Phone 20153392001005

720 Monroe St
Ste E304
Hoboken, NJ 07030

121 Newark Ave
Jersey City, NJ 07302
Phone (201) 677-2232

26 Journal Sq
Ste 402
Jersey City, NJ 07306

8841 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 858-2457

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

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.

Verify at the official NPI Registry.