Healthcare Provider Details

I. General information

NPI: 1154194827
Provider Name (Legal Business Name): ORTHO ELITE PERFORMANCE & RECOVERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 E PRINCESS DR STE 210
SCOTTSDALE AZ
85255-5441
US

IV. Provider business mailing address

11 SPUR CIR
SCOTTSDALE AZ
85251-5460
US

V. Phone/Fax

Practice location:
  • Phone: 480-216-1616
  • Fax: 480-409-5204
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTOPHER BERO
Title or Position: OWNER
Credential:
Phone: 480-216-1616