ACTIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC — NPI 1922389600 (Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) in HACKENSACK, NJ)

CMS-1500 Box 24J / 33a • NPI

1922389600

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207XX0005X (CMS 02)

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

Box 32 Service Location & ZIP+4

25 PROSPECT AVE, HACKENSACK, NJ, 07601-1960

✓ 9-Digit EDI 837 ZIP+4 (07601-1960)

Practice Phone & Referral Fax

(201) 343-2277

Fax: (201) 343-7410

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1922389600 (ACTIVE ORTHOPEDICS AND SPORTS MEDICINE, 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	`1922389600` (NPI-2 Organization / Facility)
Provider / Legal Name	ACTIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC
Plain-English Specialty	Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) NUCC Code: `207XX0005X` (Orthopaedic Surgery, Sports Medicine)
Certifying / Licensing Body	American Board of Orthopaedic Surgery (ABOS)
Practice Location Address	25 PROSPECT AVE, HACKENSACK, NJ, 07601-1960
Practice Telephone / Fax	Tel: (201) 343-2277 \| Fax: (201) 343-7410
Administrative Mailing Address	25 PROSPECT AVE, HACKENSACK, NJ, 07601-1960
Enumeration & Last Sync	Enumerated: 2011-09-08 \| CMS Record Updated: 2011-09-08
Authorized Official	MICHAEL GROSS (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

25 PROSPECT AVE, HACKENSACK, NJ, 07601-1960

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Plain-English Taxonomy & CMS Crosswalk (207XX0005X)

What Does Taxonomy Code 207XX0005X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207XX0005X translates to:
"Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 20 (Physician/Orthopedic Surgery) • CMS Code 23 (Physician/Sports Medicine)
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 (ACTIVE ORTHOPEDICS AND SPORTS MEDICINE, 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
`207XX0005X` — Orthopaedic Surgery, Sports Medicine Plain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon)	State: NJ \| License: `25MA05362900` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ACTIVE ORTHOPEDICS AND SPORTS MEDICINE, LLC (NPI #1922389600)