Ortho Shoes Corp

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

CPED 3003 Issued in DE

Legal business name

ORTHO SHOES CORP

Practice address

10032 Queens Blvd
Forest Hills, NY 11375-2748

Phone

(917) 304-6657

NPI assigned

Nov 4, 2009

Last updated

Jul 8, 2020By 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. Gabriyel Adzhiashvili, CPED

Title

President

Phone

(917) 304-6657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Ortho Shoes Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Ortho Shoes Corp

  • Durable Medical Equipment & Medical Supplies
  • Forest Hills, NY
  • NPI 1477880896
  NPD tax ID

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1255668737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10032 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752748",
            "telephone_number": "917-304-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10032 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752748",
            "telephone_number": "917-304-6657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98-36 QUEENS BLVD",
            "address_purpose": "LOCATION",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "country_code": "US",
            "telephone_number": "917-304-6657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHO SHOES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "ADZHIASHVILI",
        "authorized_official_first_name": "GABRIYEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-304-6657",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPED"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "DE",
            "license": "CPED 3003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optimum Chiropractic Health PC (Forest Hills Chiropractic and Wellness)
• Lisa Jovana Orbegoso
• Ira Orgel, DDS
• Maria Fernanda Ortega Galvis
• Fabio Andres Ortega Palomino
• Ortho Shoes Corp
• Maria Gabriela Ortiz Fiallos, M.S ED
• Sandra Patricia Ortiz Quintero
• Yuri Andres Ortiz Velez
• Bonnie Lynn Ortiz

• Customized Equipment (DME) in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Customized Equipment (DME) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.