Prosthetic Solutions Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CP003200 Issued in MI

Legal business name

PROSTHETIC SOLUTIONS INC.

Practice address

191 San Felipe Rd Ste M1
Hollister, CA 95023-3036

Phone

(831) 637-0491

Fax

(831) 637-1977

NPI assigned

Oct 21, 2008

Last updated

Jun 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Wade Thomas Skardoutos, CPNPI 1346427069

Title

President

Phone

(831) 637-0491

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Prosthetic Solutions, Inc.

  • Prosthetic/Orthotic Supplier
  • Santa Clara, CA
  • NPI 1598858284

  7517168289

  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

Prosthetic Solutions Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Prosthetic Solutions, Inc.

  • Prosthetic/Orthotic Supplier
  • Santa Clara, CA
  • NPI 1598858284
  NPD tax ID

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.

• Wade Thomas Skardoutos, CP

  • Prosthetist
  • Santa Clara, CA
  • NPI 1346427069
  NPD Authorized official

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1447402599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 SAN FELIPE RD STE M1",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233036",
            "telephone_number": "831-637-0491",
            "fax_number": "831-637-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 SAN FELIPE RD STE M1",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "950233036",
            "telephone_number": "831-637-0491",
            "fax_number": "831-637-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC SOLUTIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "SKARDOUTOS",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-637-0491",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": "CP003200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ramona Ponce, HEALTH EDUCATOR
• John Leonard Popek
• Jose Prieto, VOCATIONAL ASSISTANT
• Primex Healthcare Services Inc
• Sharon Quinn, MA, MFT
• Emily Miriam Quiroz Lopez
• Maya Torres Quiroz
• Radiology Medical Group of Santa Cruz County Inc. (Agile Radiology)
• Radx Imaging Partners Inc

• Prosthetic/Orthotic Supplier in Hollister, CA
• Providers in Hollister, 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 Jun 15, 2015; 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.