NPIMap

Individual provider Active NPI

Edwin Gregory Theosmy, D.O.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Edison, NJ
National Provider Identifier
1720435605
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
25MB11413200 Issued in NJ
Practice address
205 May St Ste 202
Edison, NJ 08837-3267
Phone
(908) 757-1520
NPI assigned
May 19, 2016
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X 25MB11413200 NJ
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 25MB11413200 NJ Primary

Addresses

Primary practice location

205 May St Ste 202
Edison, NJ 08837-3267

Mailing address

205 May St Ste 202
Edison, NJ 08837-3267
Phone (908) 757-1520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221111000527 NJ Practitioner - Orthopedic Surgery 5799180279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Rowan University School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hospital PLZ
Old Bridge, NJ 08857-3012
Phone (732) 324-5073

30 Prospect Ave
Hackensack, NJ 07601-1915

65 James St
Edison, NJ 08820-3947
Phone (732) 321-7901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement25
Knee replacement26
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB11413200NJMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 17, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Orthopaedic Surgery CurrentSince Oct 17, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1720435605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MAY ST STE 202",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373267",
            "telephone_number": "908-757-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MAY ST STE 202",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373267",
            "telephone_number": "908-757-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOSMY",
        "first_name": "EDWIN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MB11413200",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MB11413200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.