Organization Active NPI

Joint Replacement & Spine Surgical Institute LLC

  • Ambulatory Surgical Clinic/Center
  • Bridgewater, NJ
National Provider Identifier
1679284814
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
JOINT REPLACEMENT & SPINE SURGICAL INSTITUTE LLC
Practice address
1081 US Highway 22 Ste 200
Bridgewater, NJ 08807-2921
Phone
(908) 809-1000
Fax
(908) 809-1012
NPI assigned
Dec 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Mrs. Joan McKibben, RN
Title
Administrator
Phone
(908) 809-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1081 US Highway 22 Ste 200
Bridgewater, NJ 08807-2921

Mailing address

1081 US Highway 22 Ste 200
Bridgewater, NJ 08807-2921
Phone (908) 809-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230504000763 NJ Part B Supplier - Ambulatory Surgical Center 9830554427 Practice locations: Bridgewater, NJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1679284814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 US HIGHWAY 22 STE 200",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072921",
            "telephone_number": "908-809-1000",
            "fax_number": "908-809-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 US HIGHWAY 22 STE 200",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072921",
            "telephone_number": "908-809-1000",
            "fax_number": "908-809-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOINT REPLACEMENT & SPINE SURGICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "MCKIBBEN",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "908-809-1000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.