CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC — NPI 1699441667 (Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) in HERNANDO, FL)

CMS-1500 Box 24J / 33a • NPI

1699441667

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208600000X (CMS 02)

Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)

Box 32 Service Location & ZIP+4

2456 N ESSEX AVE, HERNANDO, FL, 34442-5321

✓ 9-Digit EDI 837 ZIP+4 (34442-5321)

Practice Phone & Referral Fax

(352) 513-4783

Fax: (352) 513-4810

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1699441667 (CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1699441667` (NPI-2 Organization / Facility)
Provider / Legal Name	CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC
Plain-English Specialty	Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) NUCC Code: `208600000X` (Surgery)
Certifying / Licensing Body	American Board of Orthopaedic Surgery (ABOS)
Practice Location Address	2456 N ESSEX AVE, HERNANDO, FL, 34442-5321
Practice Telephone / Fax	Tel: (352) 513-4783 \| Fax: (352) 513-4810
Administrative Mailing Address	PO BOX 689022, FRANKLIN, TN, 37068-9022
Enumeration & Last Sync	Enumerated: 2021-08-19 \| CMS Record Updated: 2023-05-04
Authorized Official	JENNIFER JACKSON (Sr Dir Prov Enrollment & Onboarding)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2456 N ESSEX AVE, HERNANDO, FL, 34442-5321

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Plain-English Taxonomy & CMS Crosswalk (208600000X)

What Does Taxonomy Code 208600000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208600000X translates to:
"Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery)
Certifying / Accrediting Authority: American Board of Orthopaedic Surgery (ABOS)
Clinical Scope: Severe knee or hip arthritis, bone fractures, torn ligaments or meniscus, rotator cuff shoulder pain, or persistent back and sciatica pain.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC)

Typical CPT / Diagnostic Procedures:

Total Knee Arthroplasty (CPT 27447) & Total Hip Arthroplasty (CPT 27130)
Arthroscopic Rotator Cuff & ACL Ligament Reconstruction
Intra-Articular Corticosteroid & Hyaluronic Acid Joint Injections (CPT 20610)
Fracture Reduction, Internal Fixation & Carpal Tunnel Release

Common Therapeutic Classes:

NSAIDs & Selective COX-2 Inhibitors (Meloxicam, Celecoxib, Naproxen)
Intra-Articular Triamcinolone Acetonide & Methylprednisolone
Postoperative Venous Thromboembolism (VTE) Prophylaxis (Apixaban, Rivaroxaban)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`133V00000X` — Dietitian, Registered Plain English: Licensed & Credentialed Dietary & Nutritional Service Providers — Dietician, Registered	State: N/A \| License: `Verified` \| Primary: Secondary
`208600000X` — Surgery Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CRYSTAL RIVER HMA PHYSICIAN MANAGEMENT LLC (NPI #1699441667)