NPIMap

Organization Active NPI

East Side Orthotics & Prosthetics, Inc.

  • Prosthetic/Orthotic Supplier
  • Eugene, OR
National Provider Identifier
1093350266
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
EAST SIDE ORTHOTICS & PROSTHETICS, INC.
Practice address
91 Madison St
Eugene, OR 97402-5013
Phone
(503) 970-8388
Fax
(503) 257-6624
NPI assigned
Nov 12, 2019
Organization subpart
Yes
Parent organization
EASTSIDE ORTHOTICS & PROSTHETICS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Ivan Sabel
Title
Ceo
Phone
(503) 257-6623

Specialties & licenses 1

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

Addresses

Primary practice location

91 Madison St
Eugene, OR 97402-5013

Mailing address

91 Madison St
Eugene, OR 97402-5013
Phone (503) 970-8388

Other identifiers 1

IdentifierTypeStateIssuer
500778749MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200207002425 OR DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 0345441846 Practice locations: Eugene, OR

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
Eastside Orthotics & Prosthetics91 Madison St, Eugene, OR 97402-5013(503) 970-8388 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses Accepts assignmentParticipating since Feb 11, 2006

National Provider Directory

National Provider Directory
Tax ID family
East Side Orthotics Prosthetics Inc4 organizations share this tax ID, including this one
Part of
East Side Orthotics Prosthetics Inc

Other organizations with this tax ID 3

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

Locations

17316 NE Halsey St
Portland, OR 97230
Phone (503) 257-6623

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1093350266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MADISON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025013",
            "telephone_number": "503-970-8388",
            "fax_number": "503-257-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MADISON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025013",
            "telephone_number": "503-970-8388",
            "fax_number": "503-257-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTSIDE ORTHOTICS & PROSTHETICS, INC.",
        "enumeration_date": "2019-11-12",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "SABEL",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-257-6623"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500778749",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.