=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376493890
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2026
-----------------------------------------------------
Last Update Date | 02/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8525 ROLLING RD STE 100
-----------------------------------------------------
City | MANASSAS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20110-3676
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-393-1667
-----------------------------------------------------
Fax | 703-393-2517
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8525 ROLLING RD STE 300
-----------------------------------------------------
City | MANASSAS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20110-3673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-393-1667
-----------------------------------------------------
Fax | 703-393-2517
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | NICHOLAS GROSSO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-393-1667
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------