MEDICARE: CENTERS FOR ADVANCED ORTHOPAEDICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1134932866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERS FOR ADVANCED ORTHOPAEDICS, LLC

Provider Business Mailing Address
First Line	:	6707 DEMOCRACY BLVD STE 504
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 E BALTIMORE ST STE 103
Second Line	:
City	:	TANEYTOWN
State	:	MD
Zip	:	21787-2279
Country	:	US
Telephone Number	:	410-756-1562
Fax Number	:	410-848-3939

Authorized Official
Title or Position	:	PRINCIPLE PHYSICIAN
Name	:	NICHOLAS PATRICK GROSSO
Credential	:	MD
Telephone Number	:	410-644-1880

Provider Enumeration Date	:	01/28/2025
Last Update Date	:	01/28/2025

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