Quad City Prosthetic Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

QUAD CITY PROSTHETIC INC

Practice address

4730 44TH St
Rock Island, IL 61201

Phone

(309) 283-0880

Fax

(309) 283-0881

NPI assigned

Oct 9, 2005

Last updated

Sep 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Amit Bhanti, CPO

Title

Ceo

Phone

(309) 676-2276

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Moline, IL
  • NPI 1194058123

  4082731120

  Same PAC ID
• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Freeport, IL
  • NPI 1518198662

  4082731120

  Same PAC ID
• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Davenport, IA
  • NPI 1578794624

  4082731120

  Same PAC ID

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

Tax ID family

Quad City Prosthetic Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Moline, IL
  • NPI 1194058123
  NPD tax ID
• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Freeport, IL
  • NPI 1518198662
  NPD tax ID
• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Peru, IL
  • NPI 1952634982
  NPD tax ID
• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Davenport, IA
  • NPI 1578794624
  NPD tax ID
• Quad City Prosthetic Inc

  • Prosthetic/Orthotic Supplier
  • Des Moines, IA
  • NPI 1932920071
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Cpo Services, Inc

  dba Comprehensive Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Peru, IL
  • NPI 1639459415

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1128816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1215925805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 W MAIN ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061953",
            "telephone_number": "800-334-5705",
            "fax_number": "888-663-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 44TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "61201",
            "telephone_number": "309-283-0880",
            "fax_number": "309-283-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITY PROSTHETIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-09",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "BHANTI",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-676-2276",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0008170232",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0933150",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS",
            "identifier": "44119",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "131131100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41788300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623820305",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Quad City Orthodontic Group, LLC (Quad City Orthodontics)
• Quad City Psychotherapy, PLLC
• Quad City Rheumatology SC
• Quest Diagnostics LLC
• Allyson Chantell Quick, LPN
• Narayanswamy V Rama Prabhu, MD

• Prosthetic/Orthotic Supplier in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Prosthetic/Orthotic Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.