NPIMap

Organization Active NPI

Advanced Orthopedic Center of Charlotte County, PA

  • Orthopaedic Surgery Physician
  • Venice, FL
National Provider Identifier
1619795317
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ADVANCED ORTHOPEDIC CENTER OF CHARLOTTE COUNTY, PA
Practice address
836 Sunset Lake Blvd Ste 102
Venice, FL 34292-7555
Phone
(941) 497-1771
Fax
(941) 492-9475
NPI assigned
Oct 1, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED ORTHOPEDIC CENTER OF CHARLOTTE COUNTY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Dale A Greenberg, MDNPI 1699773952
Title
Corporate President
Phone
(941) 629-6262

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

836 Sunset Lake Blvd Ste 102
Venice, FL 34292-7555

Mailing address

836 Sunset Lake Blvd Ste 102
Venice, FL 34292-7555
Phone (941) 497-1771

Other names 1

  • Advanced Orthopedic Center of Charlotte County, PA in Venice Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250506003503 FL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0042106528 Practice locations: Venice, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Kenneth D Levy MD PA3 organizations share this tax ID, including this one
Part of
Kenneth D Levy MD PA

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1619795317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 SUNSET LAKE BLVD STE 102",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342927555",
            "telephone_number": "941-497-1771",
            "fax_number": "941-492-9475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 SUNSET LAKE BLVD STE 102",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342927555",
            "telephone_number": "941-497-1771",
            "fax_number": "941-492-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORTHOPEDIC CENTER OF CHARLOTTE COUNTY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED ORTHOPEDIC CENTER OF CHARLOTTE COUNTY, PA",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CORPORATE PRESIDENT",
        "authorized_official_telephone_number": "941-629-6262",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Orthopedic Center of Charlotte County, PA in Venice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.