NPIMap

Organization Active NPI

Excel Orthopaedic Specialists

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Woburn, MA
National Provider Identifier
1659349462
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
Legal business name
EXCEL ORTHOPAEDIC SPECIALISTS
Practice address
200 Unicorn Park Dr
Suite 201
Woburn, MA 01801
Phone
(781) 782-1300
Fax
(781) 782-1350
NPI assigned
Mar 8, 2006
Last updated
Jul 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

Name
Karen Ianniciello
Title
Credentialing Manager
Phone
(781) 782-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X MA Primary

Addresses

Primary practice location

200 Unicorn Park Dr
Suite 201
Woburn, MA 01801

Mailing address

200 Unicorn Park Dr Ste 201
Woburn, MA 01801-3342
Phone (781) 782-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804001120 MA Part B Supplier - Clinic/Group Practice 0648241414 Receives reassigned benefits from 56 practitioners
Practice locations: Woburn, MA

National Provider Directory

National Provider Directory

Locations

200 Unicorn Park Dr
Ste 301
Woburn, MA 01801

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1659349462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR STE 201",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018013342",
            "telephone_number": "781-782-1300",
            "fax_number": "781-782-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DR",
            "address_2": "SUITE 201",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-782-1300",
            "fax_number": "781-782-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL ORTHOPAEDIC SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "IANNICIELLO",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "781-782-1300"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.