Organization Active NPI

Advanced Orthotics & Prosthetics , LLC

  • Prosthetic/Orthotic Supplier
  • Troy, NY
National Provider Identifier
1073580759
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ADVANCED ORTHOTICS & PROSTHETICS , LLC
Practice address
950 Hoosick Rd
Troy, NY 12180-6635
Phone
(518) 279-4422
Fax
(518) 279-0033
NPI assigned
Mar 2, 2006
Last updated
Aug 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Authorized official

Name
Mr. Michael V Bolton, CO
Title
Co-Owner
Phone
(518) 279-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

950 Hoosick Rd
Troy, NY 12180-6635

Mailing address

950 Hoosick Rd
Troy, NY 12180-6635
Phone (518) 279-4422

Other identifiers 6

IdentifierTypeStateIssuer
600337OtherNYMVP
52371OtherNYGHI HMO
G72541OtherNYEMPIRE BC/BS
10052506OtherNYCDPHP
7104270OtherNMAETNA
00040246000OtherNYBLUE SHIELD NENY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930031448 NY DME Supplier - Certified Orth/Pros/Pedorthist 6507977659 Practice locations: Troy, NY

Other NPIs with the same Medicare PAC ID 1

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
Advanced Orthotics & Prosthetics950 Hoosick Rd, Troy, NY 12180-6635(518) 279-4422 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses Does not accept assignmentParticipating since Oct 13, 2000

National Provider Directory

National Provider Directory
Tax ID family
Advanced Orthotics Prosthetics 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.

Locations

950 Hoosick Rd
Troy, NY 12180
Phone (518) 279-4422

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1073580759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 HOOSICK RD",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806635",
            "telephone_number": "518-279-4422",
            "fax_number": "518-279-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 HOOSICK RD",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806635",
            "telephone_number": "518-279-4422",
            "fax_number": "518-279-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORTHOTICS & PROSTHETICS , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "518-279-4422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "600337",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "52371",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "G72541",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10052506",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7104270",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NENY",
            "identifier": "00040246000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; 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.