NPIMap

Organization Active NPI

Medical Center Orthotics and Prosthetics, LLC

  • Prosthetic/Orthotic Supplier
  • Milton, MA
National Provider Identifier
1336172196
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC
Practice address
199 Reedsdale Rd
Milton, MA 02186
Phone
(617) 698-6334
Fax
(617) 698-3260
NPI assigned
Jul 7, 2006
Last updated
May 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Authorized official

Name
Bradford Neil Gardner
Title
Director
Phone
(615) 864-8783

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OrthotistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 222Z00000X
Orthotic FitterGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225000000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

199 Reedsdale Rd
Milton, MA 02186

Mailing address

2421 Linden LN
Silver Spring, MD 20910-1230
Phone (301) 585-5347

Other identifiers 6

IdentifierTypeStateIssuer
102441600OtherMAUS DEPT OF LABOR PROV ID
240254OtherMABLUE CROSS BLUE SHIELD ID
3137161OtherMACIGNA PROVIDER ID
801088OtherMATUFTS HEALTH PLAN PROV ID
800550OtherMAHARVARD PILGRIM PROV ID
1501003MedicaidMA

Other names 1

  • South Shore Orthopedic Labs Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200812001283 MA DME Supplier - Medical Supply Company With Orthotic-Prosthetic 9830304427 Practice locations: Milton, MA

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Orthotics and Prosthetics LLC9 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.

Member of 1

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

Locations

1920 L St NW
Ste 875
Washington, DC 20036
Phone (202) 507-8027

500 Lincoln St
Boston, MA 02134
Phone (617) 208-8468

2012 Renard Ct
Ste G
Annapolis, MD 21401
Phone (410) 573-2374

440 Roper Mountain Rd
Greenville, SC 29615
Phone (251) 714-6746

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780012800000",
    "number": "1336172196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 LINDEN LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101230",
            "telephone_number": "301-585-5347",
            "fax_number": "301-585-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 REEDSDALE RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "02186",
            "telephone_number": "617-698-6334",
            "fax_number": "617-698-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-864-8783"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR PROV ID",
            "identifier": "102441600",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "240254",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER ID",
            "identifier": "3137161",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN PROV ID",
            "identifier": "801088",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PROV ID",
            "identifier": "800550",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1501003",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Shore Orthopedic Labs Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Milton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.