COASTAL SPINE PC
NPI 1417985094
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Mount Laurel, NJ
About Coastal Spine Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COASTAL SPINE PC (NPI 1417985094) is a healthcare organization registered as an orthopaedic surgery of the spine in Mount Laurel, New Jersey and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through January 29, 2027 and lists Marguerite Zoltek, Billing Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
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)
Coastal Spine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
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.
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Coastal Spine PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 31D2090807
Coastal Spine · Mount Laurel, NJFrequently 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 Coastal Spine PC's NPI number?
The NPI number for Coastal Spine PC is 1417985094. It was assigned to this organization in the NPPES registry on June 30, 2006.
Where is Coastal Spine PC located?
Coastal Spine PC is located at 4000 Church Rd, Mount Laurel, NJ 08054. The listed phone number is (856) 222-4444.
What is Coastal Spine PC's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.
Is Coastal Spine PC enrolled in Medicare?
Yes. Coastal Spine PC is registered in the Medicare PECOS enrollment system.
When is Coastal Spine PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by March 31, 2027. 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 Coastal Spine PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Coastal Spine PC. 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 (3), Physical Medicine and Rehabilitation (3) and Neurosurgery (1). Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Coastal Spine PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 31D2090807) is associated with this NPI, valid through January 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Coastal Spine PC was last updated on January 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Coastal Spine Pc · NPI 1417985094
Orthopaedic Surgery of the Spine organization in Mount Laurel, New Jersey. Organization record, active in the CMS NPPES registry since June 30, 2006.
## Identity
- **NPI:** 1417985094 (Entity type: Organization)
- **Enumerated:** June 30, 2006
- **Primary specialty:** Orthopaedic Surgery - Orthopaedic Surgery of the Spine · taxonomy 207XS0117X
- **Organization subpart:** No
- **Authorized official:** Marguerite Zoltek, BILLING DIRECTOR
## Practice location
- **Address:** 4000 CHURCH RD, Mount Laurel, NJ 08054-1110
- **Phone:** (856) 222-4444
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 7 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Orthopedic Surgery (3), Physical Medicine and Rehabilitation (3), Neurosurgery (1); 5 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 21, 2010
- **Other identifiers:** Medicare NSC 5511390001 (NJ); Medicare PIN 069103 (NJ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417985094) · Data from the CMS NPPES public registry.