NPIMap

Organization Active NPI

Otto Bock Orthopedic Services LLC

  • Prosthetic/Orthotic Supplier
  • Bonita Springs, FL
National Provider Identifier
1053623645
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OTTO BOCK ORTHOPEDIC SERVICES LLC
Practice address
4061 Bonita Beach Rd Ste 104
Bonita Springs, FL 34134-4073
Phone
(800) 736-8276
Fax
(866) 642-2302
NPI assigned
Jul 12, 2010
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Kimberly Lewis
Title
Evp of Licensure
Phone
(512) 806-2756

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 1313643 FL
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

4061 Bonita Beach Rd Ste 104
Bonita Springs, FL 34134-4073

Mailing address

PO Box 734949
Dallas, TX 75373-4949
Phone (512) 806-2879

Other practice location 1

245 Airport Pulling Rd S
Naples, FL 34104-3517
Phone (239) 643-1133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130612000021 FL DME Supplier - Orthotic PersonnelDME Supplier - Medical Supply CompanyDME Supplier - Prosthetic Personnel 0446450837 Practice locations: Bonita Springs, FL

Other NPIs with the same Medicare PAC ID 8

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
Otto Bock Orthopedic Services LLC4061 Bonita Beach Rd, Bonita Springs, FL 34134-4073(800) 736-8276 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Heat & Cold Applications|Neuromuscular Elect Stimulators (NMES)/Supplies|Osteogenesis Stimulators|Pneumatic Compression Devices and/or Supplies|Traction Equipment|(TENS) Transcutaneous E… Accepts assignmentParticipating since Dec 31, 2009

National Provider Directory

National Provider Directory
Tax ID family
Otto Bock Orthopedic Services LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

4061 Bonita Beach Rd
Ste 104
Bonita Springs, FL 34134

225 Airport Rd S
Naples, FL 34104
Phone (239) 643-1133

245 Airport Rd S
Naples, FL 34104
Phone (239) 643-1133

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1053623645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734949",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753734949",
            "telephone_number": "512-806-2879",
            "fax_number": "866-642-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 BONITA BEACH RD STE 104",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344073",
            "telephone_number": "800-736-8276",
            "fax_number": "866-642-2302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Airport Pulling Rd S",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341043517",
            "country_code": "US",
            "telephone_number": "239-643-1133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OTTO BOCK ORTHOPEDIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "EVP OF LICENSURE",
        "authorized_official_telephone_number": "512-806-2756"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "1313643",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.