Organization Active NPI

American Orthotics & Prosthetics

  • Prosthetic/Orthotic Supplier
  • San Bernardino, CA
National Provider Identifier
1285965392
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
CPO02649 Issued in CA
Legal business name
AMERICAN ORTHOTICS & PROSTHETICS
Practice address
1800 Western Ave Ste 205
San Bernardino, CA 92411-1356
Phone
(909) 473-9308
Fax
(951) 367-7789
NPI assigned
Jan 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Authorized official

Name
David Steven Sulis, CPO
Title
Cpo, Owner
Phone
(951) 367-6702

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X
Prosthetic/Orthotic Supplier 335E00000X CPO02649 CA Primary

Addresses

Primary practice location

1800 Western Ave Ste 205
San Bernardino, CA 92411-1356

Mailing address

PO Box 2786
Riverside, CA 92516-2786
Phone (909) 473-9308

Other identifiers 2

IdentifierTypeStateIssuer
XA0029550MedicaidCA
CMS168487OtherCACALIFORNIA CHILDRENS SERVICES

National Provider Directory

National Provider Directory
Tax ID family
American Orthotics Prosthetics LLC2 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.

Locations

1800 Western Ave
Ste 205
San Bernardino, CA 92411
Phone (909) 473-9308

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563408000000",
    "number": "1285965392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2786",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925162786",
            "telephone_number": "909-473-9308",
            "fax_number": "951-367-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE STE 205",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111356",
            "telephone_number": "909-473-9308",
            "fax_number": "951-367-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN ORTHOTICS & PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2019-07-18",
        "status": "A",
        "authorized_official_last_name": "SULIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "CPO, OWNER",
        "authorized_official_telephone_number": "951-367-6702",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "CPO02649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XA0029550",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CHILDRENS SERVICES",
            "identifier": "CMS168487",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

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