JUPITER ORTHOPEDICS AND SPORTS MEDICINE PLLC (NPI# 1396143392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396143392 |
| Entity Type | Organization |
| Organization Name | JUPITER ORTHOPEDICS AND SPORTS MEDICINE PLLC |
| Practice Address |
2055 Military Trl Suite 204 Jupiter FL 33458-7801 |
| Practice Telephone | 5617449733 |
| Mailing Telephone | 5617449733 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | DR. WADE C VAN SICE (PHYSICIAN/SURGEON) |
| Authorized Official Telephone | 5046156325 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
ME122314 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1500356 | 05 |
| Street Address |
2055 MILITARY TRL SUITE 204 |
| City | JUPITER |
| State | FL |
| Zip Code | 33458-7801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811986920 | Thomas Mitchell Hernandez | Anesthesiology | 2055 Military Trl, Suite 100, Jupiter, FL 33458-7801 | 2005-10-20 |
| 1639618804 | Physiotherapy & Sports Rehab LLC | Physical Therapist | 2055 Military Trl, Suite 208, Jupiter, FL 33458-7801 | 2017-02-21 |
| 1801251038 | Sierra Gant | Physical Therapist | 2055 Military Trl, Suite 200, Jupiter, FL 33458-7801 | 2015-12-14 |
| 1891125969 | Ryan Urenda | Physical Therapist | 2055 Military Trl, Suite 200, Jupiter, FL 33458-7801 | 2013-11-26 |
| 1063733491 | Robin A Sykes, M.d., P.a. | Plastic Surgery | 2055 Military Trl, Suite 305, Jupiter, FL 33458-7801 | 2010-06-21 |
| 1356584239 | Emilio Musso Md Pa | Orthopaedic Surgery | 2055 Military Trl, Suite 303, Jupiter, FL 33458-7801 | 2009-04-08 |
| 1154562122 | Emilio Simone Musso | Orthopaedic Surgery | 2055 Military Trl, Suite 303, Jupiter, FL 33458-7801 | 2009-03-20 |
| 1699923177 | Frank F Cook LLC | Orthopaedic Surgery | 2055 Military Trl, Suite 204, Jupiter, FL 33458-7801 | 2008-09-08 |
| 1164600201 | Istvan Krisko, M.d., Ph.d., P.a. | Internal Medicine | 2055 Military Trl, Ste 800, Jupiter, FL 33458-7801 | 2008-01-31 |
| 1598890030 | Ars Optical Inc. | Durable Medical Equipment & Medical Supplies | 2055 Military Trl, Suite 307a, Jupiter, FL 33458-7801 | 2007-02-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538780978 | Palm Beach Concierge Pt, LLC | Physical Therapist | 1166 Egret Cir S, Jupiter, FL 33458 | 2020-04-27 |
| 1346714789 | Shirley Dumas Gilbert | Counselor | 1132 W Indiantown Rd Unit 202, Jupiter, FL 33458 | 2019-01-18 |
| 1326518986 | Donald George Williams Jr. | Pharmacist | 5500 Military Trail, Jupiter, FL 33458 | 2018-11-27 |
| 1306329693 | William A Tison IIi | Physician Assistant | 2055 Military Trail Suite 204, Jupiter, FL 33458 | 2018-09-12 |
| 1588146930 | Joanna Peros | Psychologist | 210 Jupiter Lakes Blvd. Unit 3102, Jupiter, FL 33458 | 2018-09-02 |
| 1528558301 | Brian Pratt | Registered Nurse | 871 University Blvd Apt 207, Jupiter, FL 33458 | 2018-05-16 |
| 1306352133 | Katherine Janis Rivera | Nurse Anesthetist, Certified Registered | Jupiter Medical Center 1210 Old Dixie Hwy, Jupiter, FL 33458 | 2017-12-15 |
| 1992235436 | Barborka Schmidt | Pharmacist | 6650 W Indiantown Road, Suite 100, Aarav Pharmacy LLC, Jupiter, FL 33458 | 2017-06-18 |
| 1114453834 | Elite-e Counseling | Social Worker | 2055 Military Trail Suite 306 Jupiter, Jupiter, FL 33458 | 2017-05-02 |
| 1669910667 | Kristy Lee Caronia | Nurse Anesthetist, Certified Registered | 175 Edenberry Ave, Jupiter, FL 33458 | 2017-02-09 |
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| 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 |
|---|---|---|---|---|
| 1053889444 | Ortho Florida, LLC | Orthopaedic Surgery | 2055 Military Trl Ste 204, Jupiter, FL 33458-7830 | 2018-11-05 |
| 1508354861 | Diego Jose Lopes De Lima | Orthopaedic Surgery | 875 Military Trl Ste 105, Jupiter, FL 33458-5700 | 2018-04-23 |
| 1770902249 | Zachary Mcvicker | Orthopaedic Surgery | 2055 Military Trl Ste 204, Jupiter, FL 33458-7830 | 2014-04-14 |
| 1699923177 | Frank F Cook LLC | Orthopaedic Surgery | 2055 Military Trl, Suite 204, Jupiter, FL 33458-7801 | 2008-09-08 |
| 1730337023 | David S Rondon Md Pa | Orthopaedic Surgery | 601 University Blvd, Suite 104, Jupiter, FL 33458-2788 | 2008-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801401021 | Ortho Florida, LLC | Orthopaedic Surgery | 17425 7th St Ste 560174, Montverde, FL 34756-3206 | 2020-09-14 |
| 1801429022 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Creek Rd Ste 202, Ft Lauderdale, FL 33309-1858 | 2020-02-17 |
| 1750913141 | Tyrance Orthopedics and Sports Medicine | Orthopaedic Surgery | 1620 S Congress Ave Ste 201, Palm Springs, FL 33461-2128 | 2020-02-04 |
| 1255979076 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Crk Rd Ste 202, Fort Lauderdale, FL 33309-1858 | 2019-12-11 |
| 1730740218 | Baptist Physician Group LLC | Orthopaedic Surgery | 133 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1644 | 2019-06-25 |
| 1164984720 | Ortho Florida, LLC | Orthopaedic Surgery | 21097 Ne 27th Ct Ste 590, Aventura, FL 33180-1246 | 2019-04-03 |
| 1578043998 | Bahri Orthopedics Institute | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2018-08-15 |
| 1154834489 | Dorothy Richardson | Orthopaedic Surgery | 1120 W Lakeshore Dr, Clermont, FL 34711-2936 | 2017-11-08 |
| 1225541790 | Ortho Florida, LLC | Orthopaedic Surgery | 3702 Washington St Ste 202, Hollywood, FL 33021-8283 | 2017-11-07 |
| 1275046831 | Galaxy Wellness Sport and Rehabilitation Center LLC | Orthopaedic Surgery | 1951 Nw 7th St, Miami, FL 33125 | 2017-11-06 |
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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.