Pediatric Orthotic and Prosthetic Services-Southeast, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

09 Issued in TX

Legal business name

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC

Practice address

815 Market St
Galveston, TX 77550-2725

Phone

(713) 793-3867

Fax

(713) 793-3898

NPI assigned

Oct 16, 2014

Organization subpart

Yes

Parent organization

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST LLCAs reported in NPPES

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

Authorized official

Name

Ms. Meredith Roehrs

Title

Manager

Phone

(409) 770-6639

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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).

• Pediatric Orthotic and Prosthetic Services - Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Tampa, FL
  • NPI 1386929347

  6103110739

  Same PAC ID
• Pediatric Orthotic and Prosthetic Services - Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
  • NPI 1992075295

  6103110739

  Same PAC ID
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Shreveport, LA
  • NPI 1912303330

  6103110739

  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

Pediatric Orthotic and Prosthetic Services-Southeast LLC4 organizations share this tax ID, including this one

Part of

Pediatric Orthotic and Prosthetic Services-Southeast LLC

Other organizations with this tax ID 3

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

• Pediatric Orthotic and Prosthetic Services - Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Tampa, FL
  • NPI 1386929347
  NPD tax ID
• Pediatric Orthotic and Prosthetic Services - Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
  • NPI 1992075295
  NPD tax ID
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Shreveport, LA
  • NPI 1912303330
  NPD tax ID

Member of 1

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

• Shriners Hospitals for Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1316065360

  Member Of

  NPD member

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

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1285038489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947109",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947109",
            "telephone_number": "813-367-2876",
            "fax_number": "813-518-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MARKET ST",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775502725",
            "telephone_number": "713-793-3867",
            "fax_number": "713-793-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST LLC",
        "enumeration_date": "2014-10-16",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "ROEHRS",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "409-770-6639",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "09",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlee Lynette Payne, RN, BSN
• PC Optics
• Jourdan M Pea, APRN-CNP
• Peaceful Tranquility Hospice II, Inc
• Pediatric Dental Care
• Dora Gonzalez Pedraza, FNP
• Craig Davidson Peiris, MD
• Cong Peng, DMD
• Beverly Gail Pennington, FNP
• Daniel Aubrey Penton, CRNA

• Prosthetic/Orthotic Supplier in Galveston, TX
• Providers in Galveston, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.