Active NPI
Green Prosthetics & Orthotics LLC
- Prosthetic/Orthotic Supplier
- Jamestown, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- GREEN PROSTHETICS & ORTHOTICS LLC
- Practice address
- 1290 E 2ND St
Jamestown, NY 14701-1915 - Phone
- (716) 484-1088
- Fax
- (716) 664-6192
- NPI assigned
- Jun 12, 2006
- Last updated
- Apr 26, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Rakesh Jain
- Title
- Ceo
- Phone
- (201) 774-1085
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Customized Equipment (DME) | 332BC3200X | NU | ||
| Prosthetic/Orthotic Supplier | 335E00000X | NU | Primary |
Addresses
Primary practice location
1290 E 2ND St
Jamestown, NY 14701-1915
Mailing address
1290 E 2ND St
Jamestown, NY 14701-1915
Phone (716) 484-1088
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007721900006 | Medicaid | PA | |
| 02254635 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930017824 | NY | DME Supplier - Orthotic Personnel | 1254544331 | Practice locations: Jamestown, NY |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Durable Medical Equipment & Medical Supplies
- Meadville, PA
- NPI 1013951441
1254544331
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Green Prosthetics & Orthotics LLC | Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Green Prosthetics Orthotics LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Meadville, PA
- NPI 1013951441
-
- Prosthetic/Orthotic Supplier
- Erie, PA
- NPI 1871586883
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Mobility Clinic
- Physical Therapy Clinic/Center
- Edison, NJ
- NPI 1215446489
Member Of
Locations
1290 E 2nd St
Jamestown, NY 14701
Phone (716) 484-1088
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Customized Equipment (DME)
- Edison, NJ
- NPI 1952646408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714089600000",
"number": "1346282654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 E 2ND ST",
"city": "JAMESTOWN",
"state": "NY",
"postal_code": "147011915",
"telephone_number": "716-484-1088",
"fax_number": "716-664-6192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 E 2ND ST",
"city": "JAMESTOWN",
"state": "NY",
"postal_code": "147011915",
"telephone_number": "716-484-1088",
"fax_number": "716-664-6192"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN PROSTHETICS & ORTHOTICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-12",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A",
"authorized_official_last_name": "JAIN",
"authorized_official_first_name": "RAKESH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "201-774-1085",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007721900006",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02254635",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.