NPIMap

Organization Active NPI

Pro Sports Orthopedics, Inc

  • Orthopaedic Surgery Physician
  • Brighton, MA
National Provider Identifier
1396083937
Registry record updated Jun 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PRO SPORTS ORTHOPEDICS, INC
Practice address
20 Guest St Ste 225
Brighton, MA 02135-2065
Phone
(617) 738-8642
Fax
(617) 202-4172
NPI assigned
Jan 16, 2013
Last updated
Jun 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2019

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

Authorized official

Name
Linda M Surro
Title
Systems Project Manager
Phone
(617) 491-6766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

20 Guest St Ste 225
Brighton, MA 02135-2065

Mailing address

20 Guest St Ste 225
Brighton, MA 02135-2065
Phone (617) 738-8642

Other identifiers 1

IdentifierTypeStateIssuer
110070879AMedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Associates in Orthopaedics and Sports Medicine Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Mount Auburn St
Ste 313
Cambridge, MA 02138
Phone (617) 497-9500

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1396083937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GUEST ST STE 225",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352065",
            "telephone_number": "617-738-8642",
            "fax_number": "617-202-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GUEST ST STE 225",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021352065",
            "telephone_number": "617-738-8642",
            "fax_number": "617-202-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO SPORTS ORTHOPEDICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "SURRO",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEMS PROJECT MANAGER",
        "authorized_official_telephone_number": "617-491-6766"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110070879A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.