Active NPI
Progressive Orthotics LTD
- Prosthetic/Orthotic Supplier
- Patchogue, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Legal business name
- PROGRESSIVE ORTHOTICS LTD
- Practice address
- 285 Sills Rd
Suite 8C
Patchogue, NY 11772 - Phone
- (631) 447-3860
- NPI assigned
- Aug 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bruce B Goodman, CO BOCP
- Title
- Ceo
- Phone
- (631) 732-5556
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
285 Sills Rd
Suite 8C
Patchogue, NY 11772
Mailing address
285 Sills Road
Suite 8C
Patchogue, NY 11772
Phone (631) 447-3860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00615045 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Progressive Orthotics L
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Selden, NY
- NPI 1952489163
Locations
285 Sills Rd
Bldg 8C
East Patchogue, NY 11772
Phone (631) 447-3860
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Prosthetic/Orthotic Supplier
- Selden, NY
- NPI 1952489163
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Prosthetist
- Selden, NY
- NPI 1285236661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187568000000",
"number": "1396938775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 SILLS ROAD",
"address_2": "SUITE 8C",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "631-447-3860",
"fax_number": "631-447-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 SILLS RD",
"address_2": "SUITE 8C",
"city": "PATCHOGUE",
"state": "NY",
"postal_code": "11772",
"telephone_number": "631-447-3860"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROGRESSIVE ORTHOTICS LTD",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-20",
"last_updated": "2007-08-20",
"status": "A",
"authorized_official_last_name": "GOODMAN",
"authorized_official_first_name": "BRUCE",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "631-732-5556",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CO BOCP"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00615045",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Patchogue, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.