Performance Spine and Sports Medicine East Brunswick

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

25MA09258600 Issued in NJ

Legal business name

PERFORMANCE SPINE AND SPORTS MEDICINE EAST BRUNSWICK

Practice address

555 Route 18 Ste 101
East Brunswick, NJ 08816-3727

Phone

(609) 817-0052

Fax

(609) 817-0051

NPI assigned

May 3, 2017

Last updated

Dec 11, 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

Michael Rizkalla, M.D.NPI 1477717791

Title

Administrator

Phone

(609) 817-0050

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Michael H. Rizkalla, MD

  • Physical Medicine & Rehabilitation Physician
  • Bordentown, NJ
  • NPI 1477717791
  Authorized official Same address or phone

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1497281927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9925",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086501925",
            "telephone_number": "609-817-0052",
            "fax_number": "609-817-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ROUTE 18 STE 101",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163727",
            "telephone_number": "609-817-0052",
            "fax_number": "609-817-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE SPINE AND SPORTS MEDICINE EAST BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "RIZKALLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "609-817-0050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "25MA09258600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariana Mercedez Pena, LSW
• David Pepose, PA
• Alyssa Perez Falcon
• Ina Patricia Rivera Perez, DPT
• Miriam Perez, LAC
• Performance Spine and Sports Medicine East Brunswick
• Joseph Raymond Perno, MD
• Janice Pesco, LSW
• Jodi Lynn Peska Mosseri, D.O.
• Peter Y Lee, MD, LLC

• Durable Medical Equipment & Medical Supplies in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.