Organization Active NPI

Michael B Phillips

  • Prosthetics Case Management
  • Rancho Cucamonga, CA
National Provider Identifier
1376709345
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
N/A Issued in CA
Legal business name
MICHAEL B PHILLIPS
Doing business as
Ontario Prosthetic Systems
Practice address
9253 Hermosa Ave
Suite C
Rancho Cucamonga, CA 91730-5318
Phone
(909) 466-4333
Fax
(909) 466-7040
NPI assigned
Jul 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Michael B Phillips, CPNPI 1730234709
Title
Owner/Operator
Phone
(909) 466-4333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X N/A CA Primary

Addresses

Primary practice location

9253 Hermosa Ave
Suite C
Rancho Cucamonga, CA 91730-5318

Mailing address

9253 Hermosa Ave
Suite C
Rancho Cucamonga, CA 91730-5318
Phone (909) 466-4333

Other names 1

  • Ontario Prosthetic Systems Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930048634 CA DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 1658572425 Practice locations: Rancho Cucamonga, CA

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
Michael B Phillips9253 Hermosa Ave, Rancho Cucamonga, CA 91730-5318(909) 466-4333 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 assignmentParticipating since Nov 18, 2005

National Provider Directory

National Provider Directory

Locations

9253 Hermosa Ave
Ste C
Rch Cucamonga, CA 91730
Phone (909) 466-4333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1376709345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9253 HERMOSA AVE",
            "address_2": "SUITE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305318",
            "telephone_number": "909-466-4333",
            "fax_number": "909-466-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9253 HERMOSA AVE",
            "address_2": "SUITE C",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305318",
            "telephone_number": "909-466-4333",
            "fax_number": "909-466-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL B PHILLIPS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "909-466-4333",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "CA",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ontario Prosthetic Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.