PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOC OF SOUTHERN NJ LLC
NPI 1396812574
Orthopaedic Surgery in Vineland, NJ

Q: What is Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Active since November 30, 2006

352 S DELSEA DR STE C, VINELAND, NJ 08360(856) 690-1616(856) 690-1089 Get Directions Write a Review

NPPES record last updated: April 29, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 23, 2020, Mar 5, 2020, Feb 7, 2019 (3 updates tracked since 2019).

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About Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj Llc NPPES

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

PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOC OF SOUTHERN NJ LLC (NPI 1396812574) is a healthcare organization registered as an orthopaedic surgery in Vineland, New Jersey and active in the NPI registry since November 2006. The organization maintains 4 additional practice locations and lists Verna M Shepherd, Administrator Of Physician Services, as its authorized official.

NPPES Registry Identity

NPI1396812574

Entity TypeOrganization

Primary Taxonomy207X00000X

Legal Business NamePREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOC OF SOUTHERN NJ LLC

Location Address352 S DELSEA DR STE CVineland, NJ 08360-5306

Mailing Address352 S Delsea Dr Ste CVineland, NJ 08360-5306 · (856) 690-1616 · Fax (856) 690-1089

Phone(856) 690-1616

Fax(856) 690-1089

Organization SubpartNo

Authorized OfficialVerna M ShepherdAdministrator Of Physician Services · (856) 690-1616

Enumeration DateNovember 30, 2006

Last NPPES UpdateApril 29, 20203 updates tracked since enumeration

NPPES CertifiedApril 29, 2020

✔ NPI 1396812574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NJ · MA63862

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

352 S DELSEA DR STE C, Vineland, NJ 08360

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Secondary Practice Locations 4

Location 1298 S Delsea DrVineland, NJ 08360-4568 · Phone (856) 690-1616 · Fax (856) 690-1089

Location 2556 Egg Harbor Rd Ste ASewell, NJ 08080-2326 · Phone (856) 690-1616 · Fax (856) 690-1089

Location 31004 Haddonfield RdCherry Hill, NJ 08002-2746 · Phone (856) 690-1616 · Fax (856) 690-1089

Location 4698 Mullica Hill Rd Ste 150Mullica Hill, NJ 08062-4454 · Phone (856) 690-1616 · Fax (856) 690-1089

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date 2

Next revalidation due by January 31, 2027

This provider holds 2 Medicare enrollments with upcoming revalidation dates. Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateNew JerseyEnrollment IDO20180809004403DME · Physician - General PracticeDue dateJanuary 31, 2027

StateNew JerseyEnrollment IDO20051031000150Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 35 clinicians reassign Medicare billing to Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC, which bills Medicare for the services they deliver. Of these, 28 practice at this address and 30 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 10

Orthopedic Surgery15

Physical Therapist in Private Practice7

Occupational Therapist in Private Practice4

Physical Medicine and Rehabilitation3

Anesthesiology1

Family Practice1

Internal Medicine1

Interventional Pain Management1

2 other specialties2

Nearest to this location (20)

See all 35

Laurence Fitzhenry, M.D.

Physical Medicine and Rehabilitation

NPI 1275745655

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Kimberley Smith, MD

Interventional Pain Management

NPI 1679648646

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Mohamed Albana, DO

Orthopedic Surgery

NPI 1639661762

352 S DELSEA DR UNIT C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

John Catalano, MD

Orthopedic Surgery

NPI 1659446607

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Niti Cooper, DO

Anesthesiology

NPI 1881859080

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Vincent Disabella, DO

Sports Medicine

NPI 1487632170

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Richard Diverniero, MD

Orthopedic Surgery

NPI 1609941657

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOSSame address

Thomas Dwyer, MD

Orthopedic Surgery

NPI 1972678027

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Robert Falconiero, D.O.

Orthopedic Surgery

NPI 1376500967

352 S DELSEA DR UNIT C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Trina Lisko, DO

Physical Medicine and Rehabilitation

NPI 1457471377

352 S DELSEA DR UNIT C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Benjamin Marder, DPM

Podiatry

NPI 1053706010

352 S DELSEA DR UNIT C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Chiara Mariani, MD

Physical Medicine and Rehabilitation

NPI 1225222011

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Ravin Patel, DO

Family Practice

NPI 1962039073

352 S DELSEA DR UNIT C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Adam Zucconi

Internal Medicine

NPI 1770837833

352 S DELSEA DR STE C
Vineland, NJ 08360

(856) 690-1616

✔ PECOS✔ Accepts MedicareSame address

Justin Baglivo

Physical Therapist in Private Practice

NPI 1053072488

298 S DELSEA DR
Vineland, NJ 08360

(856) 690-1616

✔ Accepts MedicareSame address

Justin Ditheodore, PT

Physical Therapist in Private Practice

NPI 1073836656

298 S DELSEA DR
Vineland, NJ 08360

(856) 690-1616

✔ Accepts MedicareSame address

Rachel Gavigan, OT

Occupational Therapist in Private Practice

NPI 1396308029

298 S DELSEA DR
Vineland, NJ 08360

(856) 690-1616

✔ Accepts MedicareSame address

John Graham, PT

Physical Therapist in Private Practice

NPI 1821032095

298 S DELSEA DR
Vineland, NJ 08360

(856) 690-1616

Same address

Brandon Hadtke, PT

Physical Therapist in Private Practice

NPI 1699485532

298 S DELSEA DR
Vineland, NJ 08360

(856) 690-1616

✔ Accepts MedicareSame address

Christopher Zeck

Physical Therapist in Private Practice

NPI 1205597630

298 S DELSEA DR
Vineland, NJ 08360

(856) 690-1616

✔ Accepts MedicareSame address

See all 35 clinicians

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

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 Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC's NPI number?

The NPI number for Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC is 1396812574. It was assigned to this organization in the NPPES registry on November 30, 2006.

Where is Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC located?

Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC is located at 352 S Delsea Dr Ste C, Vineland, NJ 08360. The listed phone number is (856) 690-1616.

What is Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC enrolled in Medicare?

Yes. Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC is registered in the Medicare PECOS enrollment system.

When is Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC holds 2 Medicare enrollments with upcoming revalidation dates. The next is due by January 31, 2027 (DME, New Jersey, Physician - General Practice). Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 35 clinicians in 10 Medicare specialties reassign their Medicare billing to Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC. A 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 the clinician's services. The largest specialties are Orthopedic Surgery (15), Physical Therapist in Private Practice (7) and Occupational Therapist in Private Practice (4). Of these, 28 practice at this address and 30 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC accept?

Health plans from Oscar Health list Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC 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 Premier Orthopaedic And Sports Medicine Assoc Of Southern Nj LLC was last updated on April 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.