NPIMap

Organization Active NPI

Sports Medicine North Orthopaedic Surgery, Inc

  • Multi-Specialty Clinic/Center
  • Gloucester, MA
National Provider Identifier
1679168652
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC
Practice address
331 Gloucester Crossing Rd
Gloucester, MA 01930-2283
Phone
(978) 818-6493
NPI assigned
Mar 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
David J Fehnel, MDNPI 1609854215
Title
President
Phone
(978) 818-6350

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
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

331 Gloucester Crossing Rd
Gloucester, MA 01930-2283

Mailing address

1 Orthopedics Dr Ste 2
Peabody, MA 01960-1669
Phone (978) 818-6493

Other identifiers 1

IdentifierTypeStateIssuer
110072100AMedicaidMA

Other names 1

  • Physical Therapy North Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040510000769 MA Part B Supplier - Clinic/Group Practice 0547259095 Receives reassigned benefits from 111 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manchester, MA; Wenham, MA; Peabody, MA; Newburyport, MA; Middleton, MA; Gloucester, MA; Beverly, MA
O20210913002217 MA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 0547259095 Practice locations: Gloucester, MA

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sports Medicine North Orthopedic Surgery Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

30 Tozer Rd
Ste 201
Beverly, MA 01915
Phone (978) 712-9081

1 Blackburn Dr
Ste 5
Gloucester, MA 01930
Phone (978) 381-2080

331 Gloucester Crossing Rd
Gloucester, MA 01930
Phone (978) 818-6493

112 Parker St
Newburyport, MA 01950
Phone (978) 255-3265

20 Henry Graf Jr Rd
Ste 1
Newburyport, MA 01950
Phone (978) 997-1500

300 Main St
Wenham, MA 01984

Practitioners & affiliated clinicians

Practitioners 112

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 112

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1679168652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR STE 2",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601669",
            "telephone_number": "978-818-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 GLOUCESTER CROSSING RD",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019302283",
            "telephone_number": "978-818-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "FEHNEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-818-6350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072100A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Physical Therapy North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gloucester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.