Organization Active NPI

Bioadvance Prosthetic Solutions, PLLC

  • Prosthetic/Orthotic Supplier
  • Allen, TX
National Provider Identifier
1235595737
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
1525 Issued in TX
Legal business name
BIOADVANCE PROSTHETIC SOLUTIONS, PLLC
Practice address
1111 Raintree Cir
Suite 150
Allen, TX 75013-4901
Phone
(972) 521-6101
Fax
(972) 521-6102
NPI assigned
Jan 13, 2016
Last updated
Nov 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Mr. Scott Wayne Williams, C.P.O., L.PNPI 1083085922
Title
Prosthetist
Phone
(972) 521-6101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 1525 TX Primary
Prosthetist 224P00000X 1525 TX

Addresses

Primary practice location

1111 Raintree Cir
Suite 150
Allen, TX 75013-4901

Mailing address

1111 Raintree Cir
Suite 150
Allen, TX 75013-4901
Phone (972) 521-6101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160506001496 TX DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 2365741766 Practice locations: Allen, TX

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
Bioadvance Prosthetic Solutions1111 Raintree Cir, Allen, TX 75013-4902(972) 521-6101 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Apr 14, 2016

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1235595737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 RAINTREE CIR",
            "address_2": "SUITE 150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750134901",
            "telephone_number": "972-521-6101",
            "fax_number": "972-521-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 RAINTREE CIR",
            "address_2": "SUITE 150",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750134901",
            "telephone_number": "972-521-6101",
            "fax_number": "972-521-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOADVANCE PROSTHETIC SOLUTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PROSTHETIST",
        "authorized_official_telephone_number": "972-521-6101",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.O., L.P"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "1525",
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "TX",
            "license": "1525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.