NPIMap

Individual provider Active NPI

John Affenita

  • Orthotist
  • Tamarac, FL
National Provider Identifier
1407247240
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
POR 160 Issued in FL
Practice address
8333 W McNab Rd
Ste 228
Tamarac, FL 33321-3242
Phone
(877) 776-8400
Fax
(877) 366-5492
NPI assigned
Feb 16, 2015
Last updated
Mar 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X POR 160 FL Primary
Prosthetist 224P00000X POR 160 FL

Addresses

Primary practice location

8333 W McNab Rd
Ste 228
Tamarac, FL 33321-3242

Mailing address

285 Sills Rd
BLDG 3 Suite D
East Patchogue, NY 11772-4869
Phone (631) 438-1075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
POR 160FLMDProsthetist

Practice roles

OrganizationSpecialtyStatusNew patients
National Brace Inc. Current Accepting new patients
Blvd Medical Supplies LLC Current Accepting new patients
Blvd Medical Supplies LLC Current Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1407247240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BLDG 3 SUITE D",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-438-1075",
            "fax_number": "877-366-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 W MCNAB RD",
            "address_2": "STE 228",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333213242",
            "telephone_number": "877-776-8400",
            "fax_number": "877-366-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFFENITA",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "FL",
            "license": "POR 160",
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "FL",
            "license": "POR 160",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.