Active NPI
Garden State Orthopaedics and Sports Medicine
- Orthopaedic Surgery Physician
- Cherry Hill, NJ
National Provider Identifier
1528132289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- GARDEN STATE ORTHOPAEDICS AND SPORTS MEDICINE
- Practice address
- 455 Route 70 West
Cherry Hill, NJ 08002 - Phone
- (856) 616-2999
- Fax
- (856) 616-1437
- NPI assigned
- Nov 17, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marc Leslie Kahn, MD
- Title
- Partner
- Phone
- (856) 616-2999
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | NU | Primary |
Addresses
Primary practice location
455 Route 70 West
Cherry Hill, NJ 08002
Mailing address
455 Route 70 West
Cherry Hill, NJ 08002
Phone (856) 616-2999
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5646804 | Medicaid | NJ | |
| D87253 | Other | BLAIR MILL AMERIHEALTH | |
| CJ9376 | Other | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Orthopaedic Surgery Physician
- Cherry Hill, NJ
- NPI 1790859460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1528132289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 ROUTE 70 WEST",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "08002",
"telephone_number": "856-616-2999",
"fax_number": "856-616-1437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 ROUTE 70 WEST",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "08002",
"telephone_number": "856-616-2999",
"fax_number": "856-616-1437"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARDEN STATE ORTHOPAEDICS AND SPORTS MEDICINE",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KAHN",
"authorized_official_first_name": "MARC",
"authorized_official_middle_name": "LESLIE",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "856-616-2999",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5646804",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLAIR MILL AMERIHEALTH",
"identifier": "D87253",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CJ9376",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.