Pediatric Orthotic and Prosthetic Services - Southeast, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

4184 Issued in FL

Legal business name

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLC

Practice address

15511 N Florida Ave Ste 102
Tampa, FL 33613-1263

Phone

(813) 975-7139

Fax

(813) 631-7160

NPI assigned

Oct 20, 2011

Organization subpart

Yes

Parent organization

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Joanne Kanas

Title

Executive Director O&P

Phone

(813) 975-7139

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

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

• Pediatric Orthotic and Prosthetic Services - Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
  • NPI 1992075295

  6103110739

  Same PAC ID
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Galveston, TX
  • NPI 1285038489

  6103110739

  Same PAC ID
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Shreveport, LA
  • NPI 1912303330

  6103110739

  Same PAC ID

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

Tax ID family

Pediatric Orthotic and Prosthetic Services-Southeast LLC4 organizations share this tax ID, including this one

Part of

Pediatric Orthotic and Prosthetic Services-Southeast LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Pediatric Orthotic and Prosthetic Services - Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Greenville, SC
  • NPI 1992075295
  NPD tax ID
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Galveston, TX
  • NPI 1285038489
  NPD tax ID
• Pediatric Orthotic and Prosthetic Services-Southeast, LLC

  • Prosthetic/Orthotic Supplier
  • Shreveport, LA
  • NPI 1912303330
  NPD tax ID

Member of 1

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

• Shriners Hospitals for Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1316065360

  Member Of

  NPD member

Locations

Practitioners 1

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

• Leslie Douglas Stewart, MD

  • Surgery Physician
  • Memphis, TN
  • NPI 1902874282
  NPD (past)

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1386929347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947109",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947109",
            "telephone_number": "813-367-2876",
            "fax_number": "813-518-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15511 N FLORIDA AVE STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131263",
            "telephone_number": "813-975-7139",
            "fax_number": "813-631-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLC",
        "enumeration_date": "2011-10-20",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "KANAS",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR O&P",
        "authorized_official_telephone_number": "813-975-7139",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "4184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004604300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Health Choice
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• Pediatric Physician Services, Inc.
• Pediatric Pulmonary Specialists PA
• Pediatric Surgery Centers, LLC
• Pediatric Therapy Associates
• Pediatrics Gastroenterology & Nutrition of Tampa Bay PA

• Prosthetic/Orthotic Supplier in Tampa, FL
• Providers in Tampa, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.