MEDICARE: CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	363LA2100X	Acute Care Nurse Practitioner	AZ
4	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician
5	207XX0801X	Orthopaedic Trauma Physician	AZ
6	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	AZ
7	208VP0000X	Pain Medicine Physician	AZ
8	208VP0014X	Interventional Pain Medicine Physician	AZ
9	213E00000X	Podiatrist	AZ
10	213ES0103X	Foot & Ankle Surgery Podiatrist	AZ
11	225100000X	Physical Therapist
12	363A00000X	Physician Assistant
13	363L00000X	Nurse Practitioner
14	207QS0010X	Sports Medicine (Family Medicine) Physician	AZ
15	207X00000X	Orthopaedic Surgery Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DD0900	OTHER	AZ	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427095801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION, LLC

Provider Business Mailing Address
First Line	:	18444 N 25TH AVE
Second Line	:	STE 310
City	:	PHOENIX
State	:	AZ
Zip	:	85023-1261
Country	:	US
Telephone Number	:	623-537-5600
Fax Number	:	866-939-2673

Provider Business Practice Location Address
First Line	:	18444 N 25TH AVE
Second Line	:	STE 210
City	:	PHOENIX
State	:	AZ
Zip	:	85023-1261
Country	:	US
Telephone Number	:	623-537-5600
Fax Number	:	866-939-2673

Authorized Official
Title or Position	:	MD -CEO
Name	:	DAVID JOSEPH JACOFSKY
Credential	:	MD
Telephone Number	:	866-974-2673

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	04/25/2025

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Directions to “CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION, LLC ” Practice Location

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