NPIMap

Organization Active NPI

Coastal Orthopaedics & Sports Medicine Center

Doing business as Coastal Orthopaedic & Sports Medicine Center

  • Specialist
  • Port Saint Lucie, FL
National Provider Identifier
1245291988
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COASTAL ORTHOPAEDICS & SPORTS MEDICINE CENTER
Doing business as
Coastal Orthopaedic & Sports Medicine Center
Practice address
7710 S US Highway 1
Port Saint Lucie, FL 34952-2320
Phone
(772) 335-5300
Fax
(772) 873-3004
NPI assigned
Mar 31, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Edward Jesus Rossario, MDNPI 1235190091
Title
President
Phone
(772) 335-5300

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

7710 S US Highway 1
Port Saint Lucie, FL 34952-2320

Mailing address

7710 S US Highway 1
Port Saint Lucie, FL 34952-2320
Phone (772) 335-5300

Other identifiers 1

IdentifierTypeStateIssuer
33747OtherFLBCBS GROUP

Other names 1

  • Coastal Orthopaedic & Sports Medicine Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL PortStLucie

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040405000753 FL Part B Supplier - Clinic/Group Practice 5294728465 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
Practice locations: Stuart, FL; Port St Lucie, FL
O20100930074249 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5294728465 Practice locations: Port Saint Lucie, FL

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7710 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 335-5300

2220 SE Ocean Blvd
Stuart, FL 34996
Phone (772) 221-1193

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1245291988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349522320",
            "telephone_number": "772-335-5300",
            "fax_number": "772-873-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349522320",
            "telephone_number": "772-335-5300",
            "fax_number": "772-873-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ORTHOPAEDICS & SPORTS MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "ROSSARIO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JESUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-335-5300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "33747",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PortStLucie",
            "affiliation": "N",
            "address_1": "7710 S US Highway 1",
            "city": "Port Saint Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349522320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coastal Orthopaedic & Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Orthopaedic & Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.