NPIMap

Organization Active NPI

Orthopaedic Associates, PA

  • Orthopaedic Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1467589010
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC ASSOCIATES, PA
Practice address
1034 Mar Walt Dr Unit 100
Fort Walton Beach, FL 32547-6637
Phone
(850) 863-2153
Fax
(850) 315-9350
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Ms. Angela Griese
Title
Software Support/Contract Manager
Phone
(850) 863-2153

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1034 Mar Walt Dr Unit 100
Fort Walton Beach, FL 32547-6637

Mailing address

PO Box 740923
Atlanta, GA 30374-0923
Phone (850) 863-2153

Other identifiers 5

IdentifierTypeStateIssuer
1467589010OtherFLMEDICARE NPI
002879600MedicaidFL
1467589010MedicaidFL
1467589010OtherFLMEDICARE NPI GROUP
DC690AOtherFLMEDICARE GROUP PIN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100610000553 FL Part B Supplier - Clinic/Group Practice 5294823084 Receives reassigned benefits from 45 practitioners
1 other NPI on this enrollment
Practice locations: Panama City, FL; Niceville, FL; Fort Walton Beach, FL; Crestview, FL; Destin, FL
O20100930036137 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 5294823084 Practice locations: Fort Walton Beach, 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

36474C Emerald Coast Pkwy
Destin, FL 32541

Interoperability endpoints

  • Direct secure messaging: dchipman@direct.orthoassociates.net
  • Direct secure messaging: tfusco@direct.orthoassociates.net
  • Direct secure messaging: mtenholder@direct.orthoassociates.net
  • Direct secure messaging: dlandry@direct.orthoassociates.net
  • Direct secure messaging: mshawbitz@direct.orthoassociates.net
  • Direct secure messaging: jthackeray@direct.orthoassociates.net
  • Direct secure messaging: tmacey@direct.orthoassociates.net
  • Direct secure messaging: jfwatt@direct.orthoassociates.net

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1467589010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740923",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740923",
            "telephone_number": "850-863-2153",
            "fax_number": "850-315-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR UNIT 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476637",
            "telephone_number": "850-863-2153",
            "fax_number": "850-315-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "GRIESE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "SOFTWARE SUPPORT/CONTRACT MANAGER",
        "authorized_official_telephone_number": "850-863-2153",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1467589010",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002879600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467589010",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI GROUP",
            "identifier": "1467589010",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "DC690A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.