Advanced Orthopaedics and Sports Medicine, PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

22110 Issued in AZ

Legal business name

ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE, PC

Practice address

1760 E Florence Blvd
Suite 120
Casa Grande, AZ 85122-4764

Phone

(520) 426-1000

Fax

(520) 426-1395

NPI assigned

Aug 30, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan K. Matanky, M.D.NPI 1205945482

Title

Owner

Phone

(520) 426-1000

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Enrollment records 2

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Advanced Orthopaedics and Sports Medicine, PC

  • Orthopaedic Surgery Physician
  • Chandler, AZ
  • NPI 1821594235
  NPPES parent name

Practitioners 5

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.

• Bryan K. Matanky, M.D.

  • Orthopaedic Surgery Physician
  • Casa Grande, AZ
  • NPI 1205945482
  Medicare reassignment Care Compare group NPD Authorized official
• Kyle D. Byrne, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Chandler, AZ
  • NPI 1689194920
  Medicare reassignment Care Compare group
• Katherine Marie Maynard, PA

  • Physician Assistant
  • Casa Grande, AZ
  • NPI 1497522486
  Medicare reassignment Care Compare group
• Vanessa Karie, PA-C

  • Surgical Physician Assistant
  • Chandler, AZ
  • NPI 1396116992
  Medicare reassignment
• Kelsy J Rokey

  • Orthopaedic Surgery Physician
  • Casa Grande, AZ
  • NPI 1689002115
  Medicare reassignment

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1417066788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 E FLORENCE BLVD",
            "address_2": "SUITE 120",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224764",
            "telephone_number": "520-426-1000",
            "fax_number": "520-426-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 E FLORENCE BLVD",
            "address_2": "SUITE 120",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224764",
            "telephone_number": "520-426-1000",
            "fax_number": "520-426-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Dobson Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852866160",
            "country_code": "US",
            "telephone_number": "520-426-1000",
            "fax_number": "520-426-1395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MATANKY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-426-1000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "22110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH9210",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "F66298",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344579",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F00672",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis H Adams, M.A., LISAC
• Tamerut Anna Adams, D.O.
• Keshia Adolpho, LCSW
• Caroline Adrian, PHARMD
• Adult Medicine Associates, PC
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• Ivey Daniell Agee Wainwright, D.D.S
• Veronica Agredano Ellis, BS

• Orthopaedic Surgery Physician in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.