Ultima Sports And Spine Llc is a medicare enrolled "Clinic/center - Multi-specialty" provider in Hawthorne, New Jersey. Their current practice location is
219 Lafayette Ave, Hawthorne, New Jersey. You can reach out to their office (for appointments etc.) via phone at
(973) 423-9100.
Ultima Sports And Spine Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Ultima Sports And Spine Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1811508641.
Healthcare Provider's Profile
| Full Name | Ultima Sports And Spine Llc |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 219 Lafayette Ave, Hawthorne, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811508641
- Provider Enumeration Date: 08/14/2020
- Last Update Date: 08/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 6901295526
- Enrollment ID: O20211119000090
Medical Identifiers
Medical identifiers for Ultima Sports And Spine Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811508641 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 111NX0800X | Chiropractor - Orthopedic | (* (Not Available)) | Secondary |
| 171100000X | Acupuncturist | (* (Not Available)) | Secondary |
| 207T00000X | Neurological Surgery | (* (Not Available)) | Secondary |
| 207X00000X | Orthopaedic Surgery | (* (Not Available)) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Ultima Sports And Spine Llc acts as a billing entity for following providers:
| Provider Name | Tara Brady |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1427028869
PECOS PAC ID: 2264465566
Enrollment ID: I20100525000570 |
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| Provider Name | Peter Berger |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1306889001
PECOS PAC ID: 7113984568
Enrollment ID: I20110317000897 |
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| Provider Name | David A Teplitsky |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1326537762
PECOS PAC ID: 7113272675
Enrollment ID: I20180625001396 |
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| Provider Name | Rita Sawaged |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1164810743
PECOS PAC ID: 7315254760
Enrollment ID: I20181002000226 |
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| Provider Name | David Richard Adin |
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| Provider Type | Practitioner - Pain Management |
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| Provider Identifiers | NPI Number: 1134117211
PECOS PAC ID: 8729032164
Enrollment ID: I20190429002653 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ultima Sports And Spine Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ultima Sports And Spine Llc
219 Lafayette Ave,
Hawthorne, NJ 07506-1904
Ph: (973) 423-9100 | Ultima Sports And Spine Llc
219 Lafayette Ave,
Hawthorne, NJ 07506-1904
Ph: (973) 423-9100 |
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