Northeast Orthopedics – Orthopaedic Surgery Physician, NPI 1043262124
Orthopaedic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Northeast Orthopedics
880 US Highway 431
Boaz, AL 359571925
Phone: (256) 547-7417
Fax: (256) 547-7414
Type: Location
507 S 4th St
Gadsden, AL 359015216
Phone: (256) 547-7417
Fax: (256) 547-7414
Type: Location
1906 Glenn Blvd SW Ste 1200
Fort Payne, AL 359683547
Phone: (256) 547-7417
Fax: (256) 547-7414
Type: Location
401 Northwood Dr
Centre, AL 359601022
Phone: (256) 547-7417
Fax: (256) 547-7414
Type: Location
800 Pelham Rd S
Jacksonville, AL 362652736
Phone: (256) 547-7417
Fax: (256) 547-7414
Type: Location
1622 South Church Street
Jacksonville, AL 36265
Phone: (256) 435-6221
Fax: (256) 435-6554
Type: Location
3102, Rainbow Drive, Morgans Crossroads, Rainbow City, Etowah County, Alabama, 35906, United States
RAINBOW CITY, AL 359065804
Phone: (256) 547-7417
Fax: (256) 547-7414
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-07-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040710000215 | O | Clinic/Group Practice | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35957)
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