121 Care LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

121 CARE LLC

Practice address

215 E 73Rd St
New York, NY 10021-3653

Phone

(855) 572-0400

NPI assigned

Jan 18, 2018

Organization subpart

Yes

Parent organization

121 CARE LLCAs reported in NPPES

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

Authorized official

Name

Andrew Cantwell PedtkeNPI 1427388362

Title

Ceo

Phone

(612) 910-4164

Specialties & licenses 1

Addresses

Part of

121 Care LLC

Locations

Practitioners 1

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

• Andrew Cantwell Pedtke, M.D.

  • Orthopaedic Surgery Physician
  • San Francisco, CA
  • NPI 1427388362
  NPD (past) Authorized official

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1164930665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 73RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213653",
            "telephone_number": "855-572-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 73RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213653",
            "telephone_number": "855-572-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "121 CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "121 CARE LLC",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "PEDTKE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "CANTWELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-910-4164"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in New York, NY
• Providers in New York, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.