MEDICARE: ADVANCED ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE PC

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	:	1184578346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED ORTHOPEDIC AND SPORTS MEDICINE INSTITUTE PC

Provider Business Mailing Address
First Line	:	301 PROFESSIONAL VIEW DR
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-7904
Country	:	US
Telephone Number	:	732-720-2555
Fax Number	:	732-720-2556

Provider Business Practice Location Address
First Line	:	3107 JOHN F. KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-2378
Country	:	US
Telephone Number	:	732-720-2555
Fax Number	:	732-720-2556

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL J GRELLER
Credential	:
Telephone Number	:	732-720-2555

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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