Mobility Prosthetic and Orthotic Services LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MOBILITY PROSTHETIC AND ORTHOTIC SERVICES LLC

Practice address

1921 Motor Ave Ste B
Kingman, AZ 86401-4185

Phone

(928) 377-4125

Fax

(928) 277-4400

NPI assigned

May 29, 2020

Organization subpart

No

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

Authorized official

Name

Raju Roy, CPO, LPO

Title

Director

Phone

(714) 390-7533

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Mobility Prosthetic and Orthotic Services LLC

  • Prosthetic/Orthotic Supplier
  • Lake Havasu City, AZ
  • NPI 1508528654

  7214351477

  Same PAC ID
• Mobility Prosthetic and Orthotic Services LLC

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1871255901

  7214351477

  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

Mobility Prosthetic and Orthotic Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mobility Prosthetic and Orthotic Services LLC

  • Prosthetic/Orthotic Supplier
  • Lake Havasu City, AZ
  • NPI 1508528654
  NPD tax ID
• Mobility Prosthetic and Orthotic Services LLC

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1871255901
  NPD tax ID

Locations

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1285258996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 MOTOR AVE STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014185",
            "telephone_number": "928-377-4125",
            "fax_number": "928-277-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 MOTOR AVE STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014185",
            "telephone_number": "928-377-4125",
            "fax_number": "928-277-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY PROSTHETIC AND ORTHOTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "RAJU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-390-7533",
        "authorized_official_credential": "CPO, LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Stagner,M.D. P.C
• Evan James Michelson
• Jack Glenn Miller, CTN
• Marc L Miller, MD
• Mindful Solutions Behavioral Health Services
• Mohave Dental Associates PC
• Mohave Desert Orthopaedic Center LLC
• Mohave Eye Center, LTD
• Mohave Eye Centers LTD
• Mohave Eye Surgery Center

• Prosthetic/Orthotic Supplier in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Prosthetic/Orthotic Supplier in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.