Advanced Orthopedic and Sports Medicine Institute – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1164984720

Advanced Orthopedic and Sports Medicine Institute is a healthcare provider. based in Boca raton, Florida. specializing in Sports Medicine (Orthopaedic Surgery) Physician. The NPI Number for Advanced Orthopedic and Sports Medicine Institute is 1164984720

Main info

Organization
Name
Advanced Orthopedic and Sports Medicine Institute
NPI
1164984720
Phone
Not provided
Address
751 PARK OF COMMERCE DR STE 112
Authorized Official
DANE TRASK CEO
Enumeration Date
3 April 2019
Last Update Date
3 April 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness80
Years active:7State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Advanced Orthopedic and Sports Medicine Institute

  • Park of Commerce Drive, Boca Raton, Palm Beach County, Florida, 33487, United States

    BOCA RATON, FL 334873622

    Phone:

    Type: Mailing

  • 21097 NE 27TH CT STE 590

    AVENTURA, FL 331801246

    Phone: (561) 300-1792

    Type: Location

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: 2019-08-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-08-31 (1012 days ago).

Enrollment records

1

Earliest due date

2023-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190802000384OPhysician - General PracticeFL2023-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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 33487)

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Reviews

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Frequently asked questions

Can I cross-check Advanced Orthopedic and Sports Medicine Institute using NPI 1164984720?
NPI 1164984720 belongs to Advanced Orthopedic and Sports Medicine Institute; compare other details if you need extra assurance.
Is Advanced Orthopedic and Sports Medicine Institute shown as active in public data?
Registry records indicate Advanced Orthopedic and Sports Medicine Institute maintains an active NPI.
What clinical focus is listed for Advanced Orthopedic and Sports Medicine Institute?
At a glance, Advanced Orthopedic and Sports Medicine Institute is tied to Sports Medicine (Orthopaedic Surgery) Physician. Clinical services aligned with this taxonomy classification.
Is Advanced Orthopedic and Sports Medicine Institute located near Boca Raton?
Advanced Orthopedic and Sports Medicine Institute currently maps to Boca Raton, Florida in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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