Odyssey Prosthetics & Orthotics Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CPO1431 Issued in CA

Legal business name

ODYSSEY PROSTHETICS & ORTHOTICS INC.

Practice address

738 S Waterman Ave Ste A4
San Bernardino, CA 92408-2355

Phone

(909) 890-0577

Fax

(909) 890-5504

NPI assigned

Jul 1, 2006

Last updated

Jul 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert A Openshaw, CPO

Title

Ceo/Owner

Phone

(909) 890-0577

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1356370423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 S WATERMAN AVE STE A4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082355",
            "telephone_number": "909-890-0577",
            "fax_number": "909-890-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 S WATERMAN AVE STE A4",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082355",
            "telephone_number": "909-890-0577",
            "fax_number": "909-890-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY PROSTHETICS & ORTHOTICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "OPENSHAW",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "909-890-0577",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "CPO1431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XB0021550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayra Ochoa
• Valerie Ochoa
• Ochuko G Diamreyan,MD. Inc (Apex Health Consultants Inc.)
• Odell Young Alternative School
• Odyssey Healthcare Operating a LP (Gentiva)
• Ladonna M Oelschlaeger, PHARMD
• Rani K Ogitani, B.A.
• William Oglesby Jr., PSY.D.
• Brendan Ogubuike
• Jessica Ogunduyile

• Prosthetic/Orthotic Supplier in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Prosthetic/Orthotic Supplier in California

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

Verify at the official NPI Registry.