SPINE SPORTS & REHABILITATION MEDICINE, P.C.
NPI 1689330342
Neuromusculoskeletal Medicine, Sports Medicine in Cedarhurst, NY

Q: What is Spine Sports & Rehabilitation Medicine, P.C.'s specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine, Sports Medicine with taxonomy code 204C00000X.

Active since November 16, 2021

123 MAPLE AVE STE LL, CEDARHURST, NY 11516(516) 703-3580(516) 531-8877 Get Directions Write a Review

NPPES record last updated: November 16, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Spine Sports & Rehabilitation Medicine, P.c. NPPES

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

SPINE SPORTS & REHABILITATION MEDICINE, P.C. (NPI 1689330342) is a healthcare organization registered as a neuromusculoskeletal medicine, sports medicine in Cedarhurst, New York and active in the NPI registry since November 2021. The organization lists Michelle Malkie Brunner, President, as its authorized official.

NPPES Registry Identity

NPI1689330342

Entity TypeOrganization

Primary Taxonomy204C00000X

Legal Business NameSPINE SPORTS & REHABILITATION MEDICINE, P.C.

Location Address123 MAPLE AVE STE LLCedarhurst, NY 11516-2240

Mailing Address359 Yale AveWoodmere, NY 11598-2039 · (516) 987-9837 · Fax (516) 531-8877

Phone(516) 703-3580

Fax(516) 531-8877

Organization SubpartNo

Authorized OfficialMichelle Malkie BrunnerPresident · (516) 987-9837

Enumeration DateNovember 16, 2021

NPPES CertifiedNovember 16, 2021

✔ NPI 1689330342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNeuromusculoskeletal Medicine, Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code204C00000X

Definition

A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/

123 MAPLE AVE STE LL, Cedarhurst, NY 11516

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Other Names 1

Other NameMichelle Malkie Brunner, M.d.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spine Sports & Rehabilitation Medicine, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Spine Sports & Rehabilitation Medicine, P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Michelle Brunner, MD

Physical Medicine and Rehabilitation

NPI 1326262064

123 MAPLE AVE LOWR LEVEL
Cedarhurst, NY 11516

(516) 703-3580

✔ PECOS✔ Accepts MedicareSame address

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 Spine Sports & Rehabilitation Medicine, P.C.'s NPI number?

The NPI number for Spine Sports & Rehabilitation Medicine, P.C. is 1689330342. It was assigned to this organization in the NPPES registry on November 16, 2021. The provider is also known as Michelle Malkie Brunner, M.D..

Where is Spine Sports & Rehabilitation Medicine, P.C. located?

Spine Sports & Rehabilitation Medicine, P.C. is located at 123 Maple Ave Ste Ll, Cedarhurst, NY 11516. The listed phone number is (516) 703-3580.

What is Spine Sports & Rehabilitation Medicine, P.C.'s specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine, Sports Medicine with taxonomy code 204C00000X.

Is Spine Sports & Rehabilitation Medicine, P.C. enrolled in Medicare?

Yes. Spine Sports & Rehabilitation Medicine, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Spine Sports & Rehabilitation Medicine, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Medicine and Rehabilitation) reassigns their Medicare billing to Spine Sports & Rehabilitation Medicine, P.C.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Spine Sports & Rehabilitation Medicine, P.C. was last updated on November 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.