ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE, PA (NPI# 1659326569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659326569 |
| Entity Type | Organization |
| Organization Name | ACTIVE ORTHOPAEDICS AND SPORTS MEDICINE, PA |
| Practice Address |
25 Prospect Ave Hackensack NJ 07601-1960 |
| Mailing Address |
390 Old Hook Rd Westwood NJ 07675-2616 |
| Practice Telephone | 2013432277 |
| Practice Fax Number | 2013437410 |
| Mailing Telephone | 2013580707 |
| Mailing Fax Number | 2013589777 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2008-12-16 |
| Authorized Official Name | MICHAEL LEE GROSS (PRESIDENT/OWNER) |
| Authorized Official Telephone | 2013580707 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
25MA08256500 | NJ | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
25MA5362900 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | RAILROAD MEDICARE | CK8050 | 01 |
| Street Address |
25 PROSPECT AVE |
| City | HACKENSACK |
| State | NJ |
| Zip Code | 07601-1960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376103432 | Katherine Amato | Physician Assistant | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2019-06-19 |
| 1013499037 | Christopher Lands | Physical Therapist | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2018-09-06 |
| 1740762889 | Marissa Martina Breeze | Physician Assistant | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2018-09-05 |
| 1538619341 | Professional Occupational & Physical Therapy, Pllc | Physical Therapist | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-10-05 |
| 1942759311 | Michelle Castro | Nurse Practitioner | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-09-27 |
| 1528516663 | Ana Maria Pimentel | Podiatrist | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-09-19 |
| 1467908418 | Julianne Roccuzzo | Physical Therapist | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-08-30 |
| 1528514544 | Janelle Bang | Physical Therapist | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-08-30 |
| 1801249651 | Adriana Hache | Physician Assistant | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-07-18 |
| 1811341068 | Melissa R Rossi | Podiatrist | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2016-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989414 | Alpha Healthcare Staffing Firm, LLC | Registered Nurse | 194 Passaic Street, Hackensack, NJ 07601 | 2020-10-15 |
| 1396350120 | Lower Limb Institute | Podiatrist | 211 Esses Street, Suite 405, Hackesack, NJ 07601 | 2020-09-09 |
| 1649825233 | Rachel Korenblit | Social Worker | 235 Main St Ste 203, Hackensack, NJ 07601 | 2019-08-09 |
| 1740846567 | Samantha Pirnat | Counselor | 426 Hudson Street, 2nd Floor, Hackensack, NJ 07601 | 2019-05-16 |
| 1881258499 | Tara Lynn Smith | Social Worker | 160 South River Street, Hackensack, NJ 07601 | 2019-04-29 |
| 1922569318 | Solomon Isakov | Dentist | 835 Prospect Ave, Suite 304, Hackensack, NJ 07601 | 2019-03-27 |
| 1114403409 | Mildred Lopez Vasquez | Home Health Aide | 12 Rowland Avenue, Hackensack, NJ 07601 | 2018-07-19 |
| 1538656582 | Zara Pharmacy LLC | Pharmacy | 57 Linden St, Hackensack, NJ 07601 | 2018-04-16 |
| 1447759048 | Maryann Hom | Social Worker | 307 Prospect Avenue, 14e, Hackensack, NJ 07601 | 2018-02-08 |
| 1699274258 | Kirsten Byrnes | Psychologist | Audrey Hepburn Children's House, Hackensack Umc, 12 Second St, Hackensack, NJ 07601 | 2018-02-08 |
| Find all providers in zip 07601 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821065863 | Francis G. Alberta | Orthopaedic Surgery | 385 Prospect Avenue, Hackensack, NJ 07601 | 2006-03-08 |
| 1639507684 | Garden State Orthocare LLC | Orthopaedic Surgery | 321 Essex St, Hackensack, NJ 07601-2066 | 2013-10-29 |
| 1871859371 | David Alexander Porter | Orthopaedic Surgery | 87 Summit Ave, Hackensack, NJ 07601-1262 | 2012-04-09 |
| 1922389600 | Active Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 25 Prospect Ave, Hackensack, NJ 07601-1960 | 2011-09-08 |
| 1578867917 | Mark Berman,md,pa | Orthopaedic Surgery | 211 Essex St, Suite 402, Hackensack, NJ 07601-3231 | 2010-12-28 |
| 1679712319 | University Orthopaedic Center Pa | Orthopaedic Surgery | 433 Hackensack Ave, 2nd Floor, Hackensack, NJ 07601-6319 | 2009-02-19 |
| 1609971373 | Frank G. Alberta, M.d., P.C. | Orthopaedic Surgery | 385 Prospect Ave, 2nd Floor, Hackensack, NJ 07601-2570 | 2006-09-14 |
| 1588688303 | Raphael S. Longobardi | Orthopaedic Surgery | 433 Hackensack Ave, Second Floor, Hackensack, NJ 07601-6319 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619536323 | Collegiate Sports Care, LLC | Orthopaedic Surgery | 345 Main St Ste 201, Madison, NJ 07940-2339 | 2019-06-07 |
| 1215443841 | North Jersey Sports Medicine & Orthopedic Center, LLC | Orthopaedic Surgery | 218 Ridgedale Ave Ste 202, Cedar Knolls, NJ 07927-2109 | 2017-12-19 |
| 1811318496 | Gotham City Orthopedics, LLC | Orthopaedic Surgery | 100 Town Square Pl Ste 208, Jersey City, NJ 07310-2778 | 2013-12-26 |
| 1124454822 | Andrew James Mostello | Orthopaedic Surgery | 205 S Orange Ave Ste C-1200, Newark, NJ 07103 | 2013-09-25 |
| 1750625430 | The Frankel Orthopedic and Sports Medicine Center LLC | Orthopaedic Surgery | 64 Central Square, Linwood, NJ 08221 | 2012-11-19 |
| 1215261037 | North Jersey Orthopaedic & Sports Medicine Institute | Orthopaedic Surgery | 6 Brighton Rd Ste 101, Clifton, NJ 07012-1647 | 2009-09-25 |
| 1154569044 | Jose Francisco Colon | Orthopaedic Surgery | 638 Mount Prospect Ave, Newark, NJ 07104-3110 | 2009-01-30 |
| 1376746362 | Diego Alberto Herrera Figueira | Orthopaedic Surgery | 236 E Westfield Avenue, Suite 203, Roselle Park, NJ 07204 | 2007-06-07 |
| 1184832255 | Frances Mary Rispoli | Orthopaedic Surgery | 426 Franklin Ave, Belleville, Belleville, NJ 07109-1503 | 2007-05-20 |
| 1063562445 | David Michael Deramo | Orthopaedic Surgery | 370 Grand Ave Ste 100, Englewood, NJ 07631-4109 | 2007-01-10 |
| Find all providers with the same taxonomy | ||||
| City | HACKENSACK |
| Zip Code | 07601 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.