Organization Active NPI

Garden State Orthopaedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Cherry Hill, NJ
National Provider Identifier
1528132289
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
5646804MedicaidNJ
D87253OtherBLAIR MILL AMERIHEALTH
CJ9376OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040408001322 NJ Part B Supplier - Clinic/Group Practice 9638163199 Receives reassigned benefits from 1 practitioner
Practice locations: Cherry Hill, NJ

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.