SRT Prosthetics & Orthotics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

SRT PROSTHETICS & ORTHOTICS LLC

Practice address

618 N High School Rd Ste B
Indianapolis, IN 46214-3684

Phone

(866) 633-3961

NPI assigned

Sep 11, 2012

Organization subpart

No

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

Authorized official

Name

Leslie Siebenaler

Title

Director of Operations

Phone

(866) 633-3961

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1255681870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E WASHINGTON ST",
            "city": "BUTLER",
            "state": "IN",
            "postal_code": "467211179",
            "telephone_number": "866-633-3961",
            "fax_number": "419-633-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 N HIGH SCHOOL RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462143684",
            "telephone_number": "866-633-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRT PROSTHETICS & ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "SIEBENALER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "866-633-3961"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200360760I",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Senthil Raj Srinivasan
• Manasa Sriperumbdur, MHSPT
• Nayan Tara Srivastava, MD
• Shivani Srivastava, M.D.
• Methee Srivatana, DO
• SRT Prosthetics & Orthotics LLC (ForMotion Clinic)
• SRT Prosthetics & Orthotics LLC (ForMotion Clinic)
• SSC Personal Services LLC
• St Annas Medical Services Inc (St Dorothys DME Supply)
• Trevor St Clair, OTR/L

• Prosthetic/Orthotic Supplier in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Prosthetic/Orthotic Supplier in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.