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ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE PA NPI 1659326569


NPI Information

NPI: 1659326569
Provider Name: ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE, PA
Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

Address:
25 PROSPECT AVE
HACKENSACK, NJ
ZIP 07601
Phone: (201) 343-2277
Get Directions

ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE, PA is a sports medicine orthopaedic surgery in Hackensack, NJ. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE, PA NPI is 1659326569. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

25 PROSPECT AVE
HACKENSACK, NJ
ZIP 07601-960
Phone: (201) 343-2277
Fax: (201) 343-7410

The provider's authorized official is Michael Lee Gross .
The authorized official title is President/owner and has the following contact phone number (201) 358-0707.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 12/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XX0005XOrthopaedic SurgerySports Medicine25MA08256500NEW JERSEYNo
2207XX0005XOrthopaedic SurgerySports Medicine25MA5362900NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1078718MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEYNJ GROUP
2CK8050OTHERNEW JERSEYRAILROAD MEDICARE
3078718MEDICARE UPINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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