NPIMap

Organization Active NPI

Wisconsin Prosthetics & Orthotics Inc

  • Prosthetic/Orthotic Supplier
  • Sheboygan, WI
National Provider Identifier
1346355252
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
WISCONSIN PROSTHETICS & ORTHOTICS INC
Practice address
1344 N Taylor Dr
Sheboygan, WI 53081-3042
Phone
(920) 803-9610
Fax
(920) 803-9611
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Michael E. Tarvin
Title
VP & Secretary
Phone
(717) 972-1100

Specialties & licenses 1

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

Addresses

Primary practice location

1344 N Taylor Dr
Sheboygan, WI 53081-3042

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325

Other identifiers 1

IdentifierTypeStateIssuer
41792100MedicaidWI

Other names 1

  • NovaCare Prosthetics & Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930050927 WI DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 4183741317 Practice locations: Sheboygan, WI

Other NPIs with the same Medicare PAC ID 1

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
Wisconsin Prosthetics & Orthotics1344 N Taylor Dr, Sheboygan, WI 53081-3042(920) 803-9610 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Wisc Ortho Appliance Co2 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.

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1346355252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813042",
            "telephone_number": "920-803-9610",
            "fax_number": "920-803-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN PROSTHETICS & ORTHOTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41792100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.