NPIMap

Organization Active NPI

Pongratz Orthotics & Prosthetics, Inc.

  • Prosthetic/Orthotic Supplier
  • Avondale, AZ
National Provider Identifier
1306226022
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
07687929 Issued in AZ
Legal business name
PONGRATZ ORTHOTICS & PROSTHETICS, INC.
Practice address
13020 W Rancho Santa Fe Blvd Ste 101
Avondale, AZ 85392-2002
Phone
(623) 444-8801
Fax
(623) 455-3776
NPI assigned
Jun 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Nichole Inman
Title
Operations Manager
Phone
(602) 222-3032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 07687929 AZ Primary

Addresses

Primary practice location

13020 W Rancho Santa Fe Blvd Ste 101
Avondale, AZ 85392-2002

Mailing address

730 N 52ND St Ste 100
Phoenix, AZ 85008-7987
Phone (602) 222-3032

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150924002702 AZ DME Supplier - Prosthetic PersonnelDME Supplier - Certified Orth/Pros/Pedorthist 3779604749 Practice locations: Avondale, AZ

Other NPIs with the same Medicare PAC ID 9

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
Pongratz Orthotics & Prosthetics in13020 W Rancho Sante Fe Blvd, Avondale, AZ 85392-2002(623) 444-8801 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 11, 1999

National Provider Directory

National Provider Directory
Tax ID family
Pongratz Orthotics Prosthetics Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1306226022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N 52ND ST STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850087987",
            "telephone_number": "602-222-3032",
            "fax_number": "602-222-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13020 W RANCHO SANTA FE BLVD STE 101",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853922002",
            "telephone_number": "623-444-8801",
            "fax_number": "623-455-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONGRATZ ORTHOTICS & PROSTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-08",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "INMAN",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "602-222-3032"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AZ",
            "license": "07687929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.