NPIMap

Organization Active NPI

Maryland Real Life Designs, LLC

  • Prosthetic/Orthotic Supplier
  • Wilmington, DE
National Provider Identifier
1295485365
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MARYLAND REAL LIFE DESIGNS, LLC
Doing business as
Real Life Prosthetics
Practice address
1815 W 13TH St Ste 4
Wilmington, DE 19806-4054
Phone
(410) 569-0606
NPI assigned
Mar 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Authorized official

Name
Jonas Walter Seeberg
Title
President
Phone
(410) 569-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1815 W 13TH St Ste 4
Wilmington, DE 19806-4054

Mailing address

3435 Box Hill Corporate Center Dr Ste D
Abingdon, MD 21009-1204

Other names 1

  • Real Life Prosthetics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sandy@reallifeprosthetics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230111001824 DE DME Supplier - Certified Orth/Pros/Pedorthist 1355453259 Practice locations: Wilmington, DE

Other NPIs with the same Medicare PAC ID 4

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Maryland Real Life Designs, LLC1815 W 13TH St, Wilmington, DE 19806-4054(302) 476-8992 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since May 3, 2001

National Provider Directory

National Provider Directory
Tax ID family
Maryland Real Life Designs LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1815 W 13th St
Ste 4
Wilmington, DE 19806
Phone (302) 571-8958

932 Washington Ave
Chestertown, MD 21620
Phone (410) 810-0530

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1295485365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 BOX HILL CORPORATE CENTER DR STE D",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091204",
            "fax_number": "410-569-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 W 13TH ST STE 4",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198064054",
            "telephone_number": "410-569-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND REAL LIFE DESIGNS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "SEEBERG",
        "authorized_official_first_name": "JONAS",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-569-0606"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandy@reallifeprosthetics.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1815 W 13th St Ste 4",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198064054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Real Life Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.