DR. ROBERT A DEFALCO JR. DO
NPI 1174554471
Orthopaedic Surgery - Sports Medicine in Hackettstown, NJ

Q: What is Robert Defalco's NPI number?

The NPI number for Robert Defalco is 1174554471. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Q: What is Robert Defalco's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Robert Defalco was last updated on January 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 05, 2006PECOS EnrolledAccepts Medicare Assignment

79.44/100

CMS Quality Rating

108 BILBY RD, SUITE 201, HACKETTSTOWN, NJ 07840(908) 684-3005(908) 684-3301 Get Directions Write a Review

NPPES record last updated: January 30, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Robert A Defalco Jr. Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROBERT A DEFALCO JR. DO (NPI 1174554471) is an individual sports medicine provider in Hackettstown, New Jersey, licensed in New Jersey (25MB069711) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of New England, College Of Osteo Medicine (1998).

NPPES Registry Identity

NPI1174554471

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameDR. ROBERT A DEFALCO JR.Credential: DO

Location Address108 BILBY RD, SUITE 201Hackettstown, NJ 07840-4174

Mailing Address108 Bilby Rd, Suite 201Hackettstown, NJ 07840-4174 · (908) 684-3005 · Fax (908) 684-3301

Phone(908) 684-3005

Fax(908) 684-3301

Sole ProprietorNo

Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 1998

Enumeration DateJuly 5, 2006

Last NPPES UpdateJanuary 30, 2014

✔ NPI 1174554471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in NJ · 25MB069711

Definition

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.

108 BILBY RD, Hackettstown, NJ 07840

Open in Google Maps ↗

Other Identifiers 1

Medicare UPINI12244NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert A Defalco Jr. Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062486756

PECOS Enrollment IDI20040819001005

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Robert Defalco reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Jersey Sports Medicine And Orthopedic Center LLC

Same address

Specialist

108 BILBY ROAD, SUITE 201
Hackettstown, NJ 07840

Reassigned Medicare billing, New Jersey enrollment
Medicare enrollment name: North Jersey Sports Medicine & Orthopedic Center, LLC
19 clinicians in this Medicare group

NPI 1619025038 (908) 684-3005

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

89 services37 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

18 services16 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

74.92

Promoting Interoperability

Improvement Activities

Cost

57.39

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

94%105 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JEROME D ROSMAN MD

Orthopaedic Surgery

108 BILBY RD, SUITE 201
HACKETTSTOWN, NJ 07840

Warren County (908) 684-3005

MRS. LOUISE A SAUNDERS WHNP-BC

Nurse Practitioner (Women's Health)

108 BILBY RD, SUITE 305
HACKETTSTOWN, NJ 07840

Warren County (908) 813-8877

LINDA A. BROWER PT

Physical Therapist

108 BILBY RD, SUITE 201
HACKETTSTOWN, NJ 07840

Warren County (908) 684-3005

NEIL M CAMPBELL DO

Obstetrics & Gynecology

108 BILBY RD, SUITE 305
HACKETTSTOWN, NJ 07840

Warren County (908) 813-8811

DANIEL ALEXANDER RODRIGUEZ ATC

Specialist/Technologist (Athletic Trainer)

108 BILBY RD, SUITE 201
HACKETTSTOWN, NJ 07840

Warren County (908) 684-3005

FRANK JOHN CORRIGAN M.D.

Orthopaedic Surgery (Hand Surgery)

108 BILBY RD, STE 201
HACKETTSTOWN, NJ 07840

Warren County (908) 684-3005

MICHAEL GUNDELL

Physician Assistant

108 BILBY RD, SUITE 201
HACKETTSTOWN, NJ 07840

Warren County (908) 684-3005

SKINTEGRATIVE SOLUTIONS LLC

Dermatology

108 BILBY RD
HACKETTSTOWN, NJ 07840

Warren County (908) 251-9419

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Defalco's NPI number?

The NPI number for Robert Defalco is 1174554471. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Where is Robert Defalco located?

Robert Defalco practices at 108 Bilby Rd Suite 201, Hackettstown, NJ 07840. The listed phone number is (908) 684-3005.

What is Robert Defalco's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Robert Defalco enrolled in Medicare?

Yes. Robert Defalco is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Robert Defalco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Robert Defalco reassigns Medicare benefits to North Jersey Sports Medicine And Orthopedic Center LLC (Hackettstown, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Defalco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Robert Defalco accept?

Health plans from Oscar Health list Robert Defalco as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Robert Defalco was last updated on January 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.