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CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION, LLC
Complete NPI Record 1427095801
Orthopaedic Surgery in Phoenix, AZ

NPI Status: Active since June 02, 2006

Contact Information

18444 N 25TH AVE
STE 210
PHOENIX, AZ
ZIP 85023
Phone: (623) 537-5600
Fax: (866) 939-2673

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Second Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Second Line Business Practice Location Address
  17. Provider Business Practice Location Address City Name
  18. Provider Business Practice Location Address State Name
  19. Provider Business Practice Location Address Postal Code
  20. Provider Business Practice Location Address Country Code If outside U S
  21. Provider Business Practice Location Address Telephone Number
  22. Provider Business Practice Location Address Fax Number
  23. Provider Enumeration Date
  24. Last Update Date
  25. Authorized Official Last Name
  26. Authorized Official First Name
  27. Authorized Official Middle Name
  28. Authorized Official Title or Position
  29. Authorized Official Telephone Number
  30. Healthcare Provider Taxonomy Code 1
  31. Provider License Number State Code 1
  32. Healthcare Provider Primary Taxonomy Switch 1
  33. Healthcare Provider Taxonomy Code 2
  34. Healthcare Provider Primary Taxonomy Switch 2
  35. Healthcare Provider Taxonomy Code 3
  36. Healthcare Provider Primary Taxonomy Switch 3
  37. Healthcare Provider Taxonomy Code 4
  38. Provider License Number State Code 4
  39. Healthcare Provider Primary Taxonomy Switch 4
  40. Healthcare Provider Taxonomy Code 5
  41. Provider License Number State Code 5
  42. Healthcare Provider Primary Taxonomy Switch 5
  43. Healthcare Provider Taxonomy Code 6
  44. Provider License Number State Code 6
  45. Healthcare Provider Primary Taxonomy Switch 6
  46. Healthcare Provider Taxonomy Code 7
  47. Provider License Number State Code 7
  48. Healthcare Provider Primary Taxonomy Switch 7
  49. Healthcare Provider Taxonomy Code 8
  50. Provider License Number State Code 8
  51. Healthcare Provider Primary Taxonomy Switch 8
  52. Healthcare Provider Taxonomy Code 9
  53. Provider License Number State Code 9
  54. Healthcare Provider Primary Taxonomy Switch 9
  55. Healthcare Provider Taxonomy Code 10
  56. Healthcare Provider Primary Taxonomy Switch 10
  57. Healthcare Provider Taxonomy Code 11
  58. Healthcare Provider Primary Taxonomy Switch 11
  59. Healthcare Provider Taxonomy Code 12
  60. Healthcare Provider Primary Taxonomy Switch 12
  61. Healthcare Provider Taxonomy Code 13
  62. Healthcare Provider Primary Taxonomy Switch 13
  63. Healthcare Provider Taxonomy Code 14
  64. Healthcare Provider Primary Taxonomy Switch 14
  65. Healthcare Provider Taxonomy Code 15
  66. Provider License Number State Code 15
  67. Healthcare Provider Primary Taxonomy Switch 15
  68. Other Provider Identifier 1
  69. Other Provider Identifier Type Code 1
  70. Other Provider Identifier State 1
  71. Other Provider Identifier Issuer 1
  72. Other Provider Identifier 2
  73. Other Provider Identifier Type Code 2
  74. Other Provider Identifier State 2
  75. Is Organization Subpart
  76. Authorized Official Credential Text
  77. Healthcare Provider Taxonomy Group 1
  78. Healthcare Provider Taxonomy Group 2
  79. Healthcare Provider Taxonomy Group 3
  80. Healthcare Provider Taxonomy Group 4
  81. Healthcare Provider Taxonomy Group 5
  82. Healthcare Provider Taxonomy Group 6
  83. Healthcare Provider Taxonomy Group 7
  84. Healthcare Provider Taxonomy Group 8
  85. Healthcare Provider Taxonomy Group 9
  86. Healthcare Provider Taxonomy Group 10
  87. Healthcare Provider Taxonomy Group 13
  88. Healthcare Provider Taxonomy Group 14
  89. Healthcare Provider Taxonomy Group 15
  90. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1427095801. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1427095801
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: UNAVAIL
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 6
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 18444 N 25TH AVE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: STE 310
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: PHOENIX
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 850231261
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 6235375600
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 8669392673
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 18444 N 25TH AVE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: STE 210
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: PHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: AZ
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 850231261
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 6235375600
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8669392673
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/2/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/25/2025
The date that a record was last updated or changed.
Authorized Official Last Name: JACOFSKY
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DAVID
The first name of the authorized official.
Authorized Official Middle Name: JOSEPH
The middle name of the authorized official.
Authorized Official Title or Position: MD -CEO
The title or position of the authorized official.
Authorized Official Telephone Number: 8669742673
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207QS0010X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: AZ
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 207X00000X
Healthcare Provider Primary Taxonomy Switch 2: Y
Healthcare Provider Taxonomy Code 3: 207XX0005X
Healthcare Provider Primary Taxonomy Switch 3: N
Healthcare Provider Taxonomy Code 4: 207XX0801X
Provider License Number State Code 4: AZ
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 4: N
Healthcare Provider Taxonomy Code 5: 2081P2900X
Provider License Number State Code 5: AZ
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 5: N
Healthcare Provider Taxonomy Code 6: 208VP0000X
Provider License Number State Code 6: AZ
Healthcare Provider Primary Taxonomy Switch 6: N
Healthcare Provider Taxonomy Code 7: 208VP0014X
Provider License Number State Code 7: AZ
Healthcare Provider Primary Taxonomy Switch 7: N
Healthcare Provider Taxonomy Code 8: 213E00000X
Provider License Number State Code 8: AZ
Healthcare Provider Primary Taxonomy Switch 8: N
Healthcare Provider Taxonomy Code 9: 213ES0103X
Provider License Number State Code 9: AZ
Healthcare Provider Primary Taxonomy Switch 9: N
Healthcare Provider Taxonomy Code 10: 225100000X
Healthcare Provider Primary Taxonomy Switch 10: N
Healthcare Provider Taxonomy Code 11: 261QM1200X
Healthcare Provider Primary Taxonomy Switch 11: N
Healthcare Provider Taxonomy Code 12: 332B00000X
Healthcare Provider Primary Taxonomy Switch 12: N
Healthcare Provider Taxonomy Code 13: 363A00000X
Healthcare Provider Primary Taxonomy Switch 13: N
Healthcare Provider Taxonomy Code 14: 363L00000X
Healthcare Provider Primary Taxonomy Switch 14: N
Healthcare Provider Taxonomy Code 15: 363LA2100X
Provider License Number State Code 15: AZ
Healthcare Provider Primary Taxonomy Switch 15: N
Other Provider Identifier 1: DD0900
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: AZ
Other Provider Identifier Issuer 1: RR MEDICARE
Other Provider Identifier 2: 341246
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: AZ
Is Organization Subpart: N
Authorized Official Credential Text: MD
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 4: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 5: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 6: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 7: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 8: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 9: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 10: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 13: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 14: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 15: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 4/25/2025