MEDICARE: CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION

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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

Other Identifiers

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

General Provider Information

NPI Number	:	1700024742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION

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	:	866-936-2673

Provider Business Practice Location Address
First Line	:	3420 S MERCY RD
Second Line	:	STE 200
City	:	GILBERT
State	:	AZ
Zip	:	85297-0419
Country	:	US
Telephone Number	:	623-537-5600
Fax Number	:	866-939-2673

Authorized Official
Title or Position	:	CHAIRMAN/CEO
Name	:	DR. DAVID JACOFSKY
Credential	:	M.D.
Telephone Number	:	623-537-5600

Provider Enumeration Date	:	01/29/2009
Last Update Date	:	01/17/2014

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

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