Orthotic and Prosthetic Lab, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

213.000099 Issued in IL

Legal business name

ORTHOTIC AND PROSTHETIC LAB, INC.

Practice address

748 Marshall Ave
Webster Groves, MO 63119-1924

Phone

(314) 968-8555

NPI assigned

Jul 28, 2005

Organization subpart

No

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

Authorized official

Name

Mr. David J Osterman

Title

President

Phone

(314) 968-8555

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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).

• Orthotic and Prosthetic Lab, Inc

  • Prosthetic/Orthotic Supplier
  • Saint Louis, MO
  • NPI 1265593115

  5496872798

  Same PAC ID
• Orthotic and Prosthetic Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Bridgeton, MO
  • NPI 1427212471

  5496872798

  Same PAC ID
• Orthotic and Prosthetic Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Saint Louis, MO
  • NPI 1467513317

  5496872798

  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

Orthotic and Prosthetic Lab 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.

• Orthotic and Prosthetic Lab, Inc

  • Prosthetic/Orthotic Supplier
  • Saint Louis, MO
  • NPI 1265593115
  NPD tax ID
• Orthotic and Prosthetic Lab, Inc

  • Prosthetic/Orthotic Supplier
  • Saint Peters, MO
  • NPI 1558422402
  NPD tax ID
• Orthotic and Prosthetic Lab, Inc

  • Durable Medical Equipment & Medical Supplies
  • Creve Coeur, MO
  • NPI 1649331596
  NPD tax ID
• Orthotic and Prosthetic Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Bridgeton, MO
  • NPI 1427212471
  NPD tax ID
• Orthotic and Prosthetic Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Saint Louis, MO
  • NPI 1467513317
  NPD tax ID

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1235139528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 MARSHALL AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631191924",
            "telephone_number": "314-968-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 MARSHALL AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631191924",
            "telephone_number": "314-968-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC AND PROSTHETIC LAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "OSTERMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-968-8555",
        "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": "IL",
            "license": "213.000099",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "211.000024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621818608",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Webster Groves, MO
• Providers in Webster Groves, MO by specialty
• Prosthetic/Orthotic Supplier in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.