Spire Orthopedic Partners

What Spire Orthopedic Partners does

Spire Orthopedic Partners operates as a management services organization (MSO) that provides capital, operational infrastructure, and management support to market-leading orthopedic and spine physician practices across the Northeast United States. The legal entity is ONS MSO, LLC, headquartered at 5 High Ridge Park, Stamford, Connecticut, with operations across Connecticut, New York, Massachusetts, and Rhode Island. Spire is majority physician-owned and is backed by private equity firm Kohlberg & Company, which has organized eleven private equity vehicles totaling more than $15 billion in aggregate capital commitments.

The platform partners with seven anchor practices — Orthopaedic & Neurosurgery Specialists (ONS), Sports Medicine North, Middlesex Orthopedic & Spine Associates (MOSA), Orthopaedic Associates of Manhasset (OAM), Orthopedic Associates of Dutchess County (OADC), Ortho Rhode Island, and Orthopaedic Surgical Associates — collectively employing 170+ fellowship-trained orthopedic and spine physicians, 285 additional clinical providers (physician assistants and physical therapists), and approximately 2,000 total employees across 40 clinical locations, 5 ambulatory surgery centers, and 9 MRI centers. The MSO stack is organized around five service modules: Growth (partnerships, M&A, new clinic development), Operations (facilities, scheduling, ASC and MRI development), Finance (revenue cycle, billing, payor contracting, payroll), Technology (IT infrastructure, information security, data analytics, EMR/PACS informatics), and Administration (HR, benefits, regulatory compliance, legal, MACRA/MIPS reporting). Each partner practice retains its clinical autonomy and existing market brand under a Clinical Governance Board model.

Spire generates revenue through management services fees charged to affiliated practices in exchange for administrative, operational, financial, technology, and compliance support; underlying clinical revenue accrues to the practices. Its go-to-market is enterprise, field-based, and transaction-driven: Spire targets high-growth, market-leading orthopedic and spine practices via a structured three-step process (introductory meetings and NDA, preliminary due diligence with letter of intent, and confirmatory diligence with definitive agreements). Differentiated clinical capabilities include the in-network MACI Arthro surgical technique, which received FDA approval in August 2024. Recurring third-party validation includes consecutive U.S. News & World Report Best Ambulatory Surgery Center awards for the Stamford ASC (2024, 2025) and a 2025 Best ASC recognition for the Orthopedic Surgical Center of the North Shore. The platform has scaled materially since 2023 through the OADC acquisition (February 2023) and the Ortho Rhode Island acquisition (June 2024), and is now led by a newly assembled C-suite including CEO Dr. Shaden Marzouk (effective May 2026), COO Leigh Herzog, CFO George Batton, and dual CMOs Dr. Katie Vadasdi and Dr. David Hergan.

Name

Spire Orthopedic Partners

Legal name

ONS MSO, LLC

Website

https://spireortho.com

Company type

Private

Founded year

2021

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Spire Orthopedic Partners is a Kohlberg & Company-backed, majority physician-owned management services organization providing capital and administrative infrastructure to seven leading orthopedic and spine practices across the Northeast, spanning 170+ physicians, 40 locations, and 5 ASCs in CT, NY, MA, and RI.

Ownership category

akta.pro rank

Product category

Orthopedic Practice Management Services

NAICS

Offices of Physicians (except Mental Health Specialists) (621111), Offices of Physicians (62111)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Specialty Outpatient Facilities, Nec (8093)

akta.pro primary industry

Orthopedic & Spine Surgery Centers (HLAFAIAG)

akta.pro secondary industries

Hospital Shared Services, GPOs & System Support Organizations (HLAFAAAO), Multi-Specialty Ambulatory Surgery Centers (ASCs) (HLAFAIAA)

Keywords

• Orthopedic management services
• Physician practice management
• Ambulatory surgery centers
• Musculoskeletal care
• Practice administration

Headquarters

HQ city

Singapore

HQ country

Singapore

HQ region

Asia

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. Management Services Fees: Spire operates as a management services organization (MSO) providing infrastructure for administrative operations to affiliated orthopedic practices. Revenue is generated through management fees charged to partner practices in exchange for operational support, financial management, technology, compliance, HR, and other administrative services. Practices retain their clinical autonomy and unique market brands while benefiting from Spire's centralized resources.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels5 records

Core offering

Spire Orthopedic Partners operates as a management services organization (MSO) providing administrative infrastructure, growth capital, and operational support to a network of market-leading orthopedic and spine physician practices across the Northeast US. The company partners with independent orthopedic practices, allowing them to retain their brands and clinical autonomy while gaining access to centralized services in finance, technology, operations, growth, and administration. Its network encompasses 170+ physicians across 40 clinical locations, five ambulatory surgery centers, and nine MRI centers in Connecticut, New York, Massachusetts, and Rhode Island.

Product overview

Spire Orthopedic Partners operates as a management services organization (MSO) that provides infrastructure for administrative operations to a network of premier orthopedic and spine practices across the Northeast. The platform unifies multiple partner practices under their existing market-leading brands, including Orthopaedic & Neurosurgery Specialists (ONS), Sports Medicine North, Middlesex Orthopedic & Spine Associates (MOSA), Orthopaedic Associates of Manhasset (OAM), Orthopedic Associates of Dutchess County (OADC), Ortho Rhode Island, and Orthopaedic Surgical Associates. These practices collectively employ over 170 physicians across 40+ locations and multiple ambulatory surgery centers. The MSO platform provides integrated services across growth (affiliations, mergers and acquisitions), operations (facilities, scheduling), finance (revenue cycle, billing), technology (IT, EMR/PACS), and administration (HR, compliance). The network also includes ancillary services such as MRI facilities, physical therapy, and ambulatory surgery centers, with practices offering subspecialty care including sports medicine, joint replacement, spine surgery, hand/upper extremity, foot/ankle, trauma, and orthopedic oncology.

Differentiator

Problem solved

Functional benefit

Products and services

• Management Services Organization (MSO) Platform
• Ortho Rhode Island
• Orthopedic Associates of Dutchess County (OADC)
• Stamford Ambulatory Surgical Center
• Orthopedic Surgical Center of the North Shore (OSCNS)

Quantifiable outcome

• U.S. News & World Report named The Stamford Ambulatory Surgical Center Best ASC for Orthopedics and Spine for 2024 and 2025, the only surgical center in Connecticut to earn this rating
• +3 more outcomes

Named customers7 records

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Four partnerships are on record, tiered core, flagship and minor.

• Premier Lacrosse League (PLL) and Maybelline Women's Lacrosse League (WLL)coreGTM or Marketing Partner · 10 February 2025Multi-year partnership naming ONS (Orthopaedic & Neurosurgery Specialists), Spire's Greenwich, Connecticut practice, as the Official Orthopedic, Athletic Training, and Physical Therapy Partner of both leagues. ONS provides world-class medical expertise, injury prevention strategies, and rehabilitation support to PLL and WLL athletes led by Drs. Tim Greene and Paul Sethi. The partnership includes on-site medical support at PLL and WLL events, injury prevention programming, and access to ONS facilities. Dr. Paul Sethi serves as CMO of PLL and Dr. Katherine Vadasdi provides women's sports medicine expertise.
• Ortho Rhode IslandflagshipStrategic or Co-development Partner · 26 June 2024Partnership with Ortho Rhode Island and its affiliated ambulatory surgery center. Formed in 2015 from merger of four prominent Rhode Island practices, Ortho RI provides clinical care across six locations and a state-of-the-art ASC. Known for robotic assisted surgery, minimally invasive arthroscopy, and orthobiologics treatments. Dr. Michael Bradley serves as President, CEO, and CMO. Practice continues under current brand. Partnership created largest orthopedic platform in the Northeast.
• Orthopedic Associates of Dutchess County (OADC)flagshipStrategic or Co-development Partner · 13 February 2023Partnership with Poughkeepsie, NY-based OADC and its affiliated ambulatory surgery center (SCOA). Founded in 1975, OADC is the largest and most established orthopedic practice in the Hudson Valley with 24 sub-specialty trained physicians across five clinical locations and a state-of-the-art ASC. Dr. William Colman serves as Managing Partner. Transaction transformed Spire into one of the largest orthopedic platforms in the US.
• ONS FoundationminorStrategic or Co-development PartnerResearch and academia arm of Orthopaedic & Neurosurgery Specialists providing professional growth and learning opportunities for physicians within the Spire network.

Scale indicators13 records

Recent moves8 records

Expansion highlights7 records

Broad incumbents

• GenesisCare: Large multi-specialty outpatient care platform with significant oncology and musculoskeletal exposure, previously led by Spire's incoming CEO Dr. Shaden Marzouk. Comparable as a multi-site physician-network operator, though more diversified across specialties and geographies.
• HCA Healthcare: Largest U.S. for-profit hospital operator with significant orthopedic service lines and physician employment strategies. Competes indirectly for surgeon talent and orthopedic procedural volume across Spire's Northeast markets.
• Hospital for Special Surgery (HSS): Nationally recognized specialty orthopedic hospital with affiliated physician practices. While hospital-owned and academic, HSS competes for high-acuity orthopedic cases, top surgeon talent, and patient referrals in the same Northeast market.
• Tenet Healthcare / United Surgical Partners International (USPI): Largest owner and operator of ambulatory surgery centers in the U.S. through USPI. Competes for ASC joint ventures, outpatient orthopedic volume, and payor contracts that Spire's network ASCs depend on.

Direct peers

• Healthcare Outcomes Performance Company (HOPCo): Large orthopedic and musculoskeletal MSO that partners with health systems and physician groups to manage orthopedic service lines. Highly comparable to Spire in target customers (orthopedic practices and health systems) and bundled payment/musculoskeletal care management capabilities.
• U.S. Orthopedic Partners: PE-backed management services organization supporting orthopedic and spine practices across the U.S. Spire's most direct competitor for physician practice acquisitions, employing a similar physician-led partnership model and pursuing the same Northeast and Southeast geographies.
• Orthopedic Care Partners: PE-backed orthopedic practice management platform that partners with leading orthopedic groups. Closely comparable business model—physician-owned platform with growth capital and MSO support—making it a direct competitor for acquisition targets and surgeon talent.
• Twin Cities Orthopedics: Large multi-specialty orthopedic group with a similar physician partnership culture and integrated ASC/MRI/PT model. While Midwest-based (minimizing geographic overlap), it serves as a comparable platform in scale and service-line breadth.
• Rothman Orthopaedic Institute: One of the largest U.S. orthopedic specialty practices with a similar multi-specialty, multi-location model and academic affiliations. While independent rather than PE-backed, Rothman competes for the same specialist talent, patients, and surgical volumes in the Northeast corridor.

Emerging players

• SurgCenter Development: ASC development and management company that partners with physicians to develop and operate outpatient surgery centers, including orthopedic-focused ASCs. Comparable in its ASC focus and physician-partnership approach, though broader in surgical specialty coverage.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/spireortho

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles16 records

Subsidiaries9 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Spire Orthopedic Partners