Beverly Orthopedic Laboratory Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BEVERLY ORTHOPEDIC LABORATORY INC

Practice address

801 N. Tustin Ave
#203
Santa Ana, CA 92705

Phone

(657) 247-4301

Fax

(657) 247-4320

NPI assigned

Feb 18, 2021

Organization subpart

Yes

Parent organization

BEVERLY ORTHOPEDIC LABORATORY INCAs reported in NPPES

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

Authorized official

Name

Sanjay Suresh KawankarNPI 1689844813

Title

Ceo / Cfo Practice Manager

Phone

(323) 727-2887

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Beverly Orthopedic Laboratory Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Beverly Orthopedic Laboratory Inc

  • Prosthetic/Orthotic Supplier
  • Montebello, CA
  • NPI 1558370023
  NPPES parent name

Practitioners 1

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

• Sanjay Suresh Kawankar

  • Prosthetics Case Management
  • Montebello, CA
  • NPI 1689844813
  NPD (past) Authorized official

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1407449648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W. BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "90640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N. TUSTIN AVE",
            "address_2": "#203",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "657-247-4301",
            "fax_number": "657-247-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY ORTHOPEDIC LABORATORY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEVERLY ORTHOPEDIC LABORATORY INC",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "KAWANKAR",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_middle_name": "SURESH",
        "authorized_official_title_or_position": "CEO / CFO PRACTICE MANAGER",
        "authorized_official_telephone_number": "323-727-2887"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XC0008150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saul Betancourt
• Jennifer B Bettencourt-Navarro
• Better Choice Dental
• Nicole Betts
• Stephanie Jean Beverley, BSN, RN, PHN
• Beyond Blindness
• Beyond Home Health Care Co
• Britany Ayanna Beza
• Ravi Prakash Bhakta
• Shiv Bhakta

• Prosthetic/Orthotic Supplier in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.