Individual provider Active NPI

Alexander Joseph Visco, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Hoboken, NJ
National Provider Identifier
1205968310
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
25MA07808900 Issued in NJ
Practice address
720 Monroe St Ste E304
Hoboken, NJ 07030-6352
Phone
(201) 533-9200
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 231025-3 NY
Physical Medicine & Rehabilitation Physician 208100000X 25MA07808900 NJ Primary

Addresses

Primary practice location

720 Monroe St Ste E304
Hoboken, NJ 07030-6352

Mailing address

720 Monroe St Ste E304
Hoboken, NJ 07030-6352
Phone (201) 533-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000831 NJ Practitioner - Physical Medicine and Rehabilitation 2860430352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers New Jersey Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
East Coast Spine Joint and Sports MedicineGroup PAC ID 2365530938, 14 clinicians

Practice addresses (Care Compare)

720 Monroe St
Suite C 208
Hoboken, NJ 07030-5000

739 Bloomfield St
Apt 1
Hoboken, NJ 07030-5000
Phone (201) 533-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
231025-3NYMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
East Coast Spine Joint and Sports Medicine Physical Medicine & Rehabilitation CurrentSince Nov 1, 2007 Accepting new patients

Locations

720 Monroe St
Ste E304
Hoboken, NJ 07030

720 Monroe St
Ste C208
Hoboken, NJ 07030
Phone 20153392001005

Interoperability endpoints

  • Direct secure messaging: alexander.visco@direct.bayonnemedicalcenter.md

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1205968310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 MONROE ST STE E304",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306352",
            "telephone_number": "201-533-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MONROE ST STE E304",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306352",
            "telephone_number": "201-533-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCO",
        "first_name": "ALEXANDER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "231025-3",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MA07808900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.