Organization Active NPI

East Coast Orthotic & Prosthetic Corp

  • Prosthetic/Orthotic Supplier
  • Hawthorne, NY
National Provider Identifier
1083843312
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
EAST COAST ORTHOTIC & PROSTHETIC CORP
Practice address
19 Bradhurst Ave
Suite 500N
Hawthorne, NY 10532-2140
Phone
(914) 347-2220
Fax
(914) 347-2480
NPI assigned
Jul 8, 2009
Organization subpart
Yes
Parent organization
EAST COAST ORTHOTIC & PROSTHETIC CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Authorized official

Name
Mr. Lawrence J. Benenati
Title
President
Phone
(631) 392-2228

Specialties & licenses 2

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

Addresses

Primary practice location

19 Bradhurst Ave
Suite 500N
Hawthorne, NY 10532-2140

Mailing address

75 Burt Dr
Deer Park, NY 11729-5701
Phone (631) 254-5577

Other identifiers 1

IdentifierTypeStateIssuer
01749013MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110415000215 NY DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-Prosthetic 1153442009 Practice locations: Hawthorne, NY

Other NPIs with the same Medicare PAC ID 3

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
East Coast Orthotic and Prosthetic19 Bradhurst Ave, Hawthorne, NY 10532-2140(914) 347-2220 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|(TENS) Transcutaneous Electrical Nerve Sti… Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
East Coast Orthotic Prosthetic Corp4 organizations share this tax ID, including this one
Part of
East Coast Orthotic Prosthetic Corp

Other organizations with this tax ID 3

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

Locations

19 Bradhurst Ave
Ste 500N
Hawthorne, NY 10532
Phone (914) 347-2220

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541116800000",
    "number": "1083843312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BURT DR",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295701",
            "telephone_number": "631-254-5577",
            "fax_number": "631-254-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "SUITE 500N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-347-2220",
            "fax_number": "914-347-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST ORTHOTIC & PROSTHETIC CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST COAST ORTHOTIC & PROSTHETIC CORP",
        "enumeration_date": "2009-07-08",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "BENENATI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-392-2228",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01749013",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.