Organization Active NPI

Spine & Trauma Institute

  • Orthopaedic Surgery of the Spine Physician
  • Cliffside Park, NJ
National Provider Identifier
1245361963
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
SPINE & TRAUMA INSTITUTE
Practice address
663 Palisade Ave
Suite 302
Cliffside Park, NJ 07010-3012
Phone
(201) 943-9100
Fax
(201) 943-7308
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Dr. Howard M Baruch, MDNPI 1023025236
Title
President
Phone
(201) 833-9500

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
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

663 Palisade Ave
Suite 302
Cliffside Park, NJ 07010-3012

Mailing address

111 Galway PL
Teaneck, NJ 07666-3606
Phone (201) 833-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070517000230 NJ Part B Supplier - Clinic/Group Practice 5294832762 Receives reassigned benefits from 2 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

1255 Broad St
Ste 201B
Bloomfield, NJ 07003
Phone (201) 833-9500

111 Galway Pl
Ste 300
Teaneck, NJ 07666
Phone (201) 833-9500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1245361963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GALWAY PL",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663606",
            "telephone_number": "201-833-9500",
            "fax_number": "201-862-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 PALISADE AVE",
            "address_2": "SUITE 302",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070103012",
            "telephone_number": "201-943-9100",
            "fax_number": "201-943-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & TRAUMA INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "BARUCH",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-833-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.