Organization Active NPI

Center for Prosthetics Orthotics, Inc.

  • Prosthetics Case Management
  • Seattle, WA
National Provider Identifier
1396749990
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
PS00000002 Issued in WA
Legal business name
CENTER FOR PROSTHETICS ORTHOTICS, INC.
Practice address
411 12TH Ave
Seattle, WA 98122-5577
Phone
(206) 328-4276
Fax
(206) 328-1037
NPI assigned
Jun 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Authorized official

Name
Jose Ignacio, CPO
Title
Owner
Phone
(206) 328-4276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X SINGLE SPECIALTY GROUP 1744P3200X PS00000002 WA Primary

Addresses

Primary practice location

411 12TH Ave
Seattle, WA 98122-5577

Mailing address

411 12TH Ave
Seattle, WA 98122-5577
Phone (206) 328-4276

Other identifiers 1

IdentifierTypeStateIssuer
9015561MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930038609 WA DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 3274650288 1 other NPI on this enrollment
Practice locations: Seattle, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Center for Pros Ortho I3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292976000000",
    "number": "1396749990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 12TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225577",
            "telephone_number": "206-328-4276",
            "fax_number": "206-328-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 12TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225577",
            "telephone_number": "206-328-4276",
            "fax_number": "206-328-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PROSTHETICS ORTHOTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-12-22",
        "status": "A",
        "authorized_official_last_name": "IGNACIO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-328-4276",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "WA",
            "license": "PS00000002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9015561",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.