Allegiance Orthopedic Neurosurgery and Spine Institute LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ALLEGIANCE ORTHOPEDIC NEUROSURGERY AND SPINE INSTITUTE LLC

Doing business as

Blackstone Medical Group LLC

Practice address

190 Congress Park Dr Ste 160
Delray Beach, FL 33445-4707

Phone

(561) 306-5383

NPI assigned

Jan 18, 2019

Organization subpart

No

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

Authorized official

Name

Diane Ricca

Title

Managing Partner/Owner

Phone

(561) 306-5383

Specialties & licenses 1

Addresses

Other names 1

• Blackstone Medical Group LLC Doing business as

Locations

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1346714797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CONGRESS PARK DR STE 160",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334454707",
            "telephone_number": "561-306-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CONGRESS PARK DR STE 160",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334454707",
            "telephone_number": "561-306-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANCE ORTHOPEDIC NEUROSURGERY AND SPINE INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "RICCA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "MANAGING PARTNER/OWNER",
        "authorized_official_telephone_number": "561-306-5383"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blackstone Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blackstone Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Delray Beach, FL
• Providers in Delray Beach, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.