NPIMap

Organization Active NPI

North Jersey Sports Medicine and Orthopedic Center

  • Physician Assistant
  • Hackettstown, NJ
National Provider Identifier
1609311398
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00420400 Issued in NJ
Legal business name
NORTH JERSEY SPORTS MEDICINE AND ORTHOPEDIC CENTER
Doing business as
The Orthopedic Institute of NJ
Practice address
108 Bilby Rd
Suite 201
Hackettstown, NJ 07840-4174
Phone
(908) 684-3005
Fax
(908) 684-3301
NPI assigned
Jan 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Authorized official

Name
Dr. Robert A Defalco Jr., DONPI 1174554471
Title
Managing Partner
Phone
(908) 684-3005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 25MP00420400 NJ Primary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X 25MP00420400 NJ

Addresses

Primary practice location

108 Bilby Rd
Suite 201
Hackettstown, NJ 07840-4174

Mailing address

108 Bilby Rd
Suite 201
Hackettstown, NJ 07840-4174
Phone (908) 684-3005

Other names 1

  • The Orthopedic Institute of NJ Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Jersey SP Med Orthop7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1609311398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BILBY RD",
            "address_2": "SUITE 201",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404174",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BILBY RD",
            "address_2": "SUITE 201",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404174",
            "telephone_number": "908-684-3005",
            "fax_number": "908-684-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY SPORTS MEDICINE AND ORTHOPEDIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "DEFALCO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "908-684-3005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00420400",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00420400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Orthopedic Institute of NJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hackettstown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.