NPIMap

Organization Active NPI

Green Prosthetics & Orthotics LLC

  • Durable Medical Equipment & Medical Supplies
  • Meadville, PA
National Provider Identifier
1013951441
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GREEN PROSTHETICS & ORTHOTICS LLC
Practice address
279 North St
Meadville, PA 16335-2521
Phone
(814) 337-1159
Fax
(814) 337-7710
NPI assigned
Jun 15, 2006
Last updated
Apr 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Rakesh JainNPI 1952646408
Title
Ceo
Phone
(201) 774-1085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Customized Equipment (DME) 332BC3200X NU
Prosthetic/Orthotic Supplier 335E00000X 6000005987 PA

Addresses

Primary practice location

279 North St
Meadville, PA 16335-2521

Mailing address

279 North St
Meadville, PA 16335-2521
Phone (814) 337-1159

Other identifiers 3

IdentifierTypeStateIssuer
02254635MedicaidNY
0322029MedicaidOH
1007721900003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930031292 PA DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic PersonnelDME Supplier - Pedorthic Personnel 1254544331 Practice locations: Meadville, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Green Prosthetics & Orthotics LLC279 North St, Meadville, PA 16335-2521(814) 337-1159 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Apr 17, 2002

National Provider Directory

National Provider Directory
Tax ID family
Green Prosthetics Orthotics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1013951441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 NORTH ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352521",
            "telephone_number": "814-337-1159",
            "fax_number": "814-337-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 NORTH ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352521",
            "telephone_number": "814-337-1159",
            "fax_number": "814-337-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN PROSTHETICS & ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "RAKESH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-774-1085",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "PA",
            "license": "6000005987",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02254635",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0322029",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007721900003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.