Prosthetic Center of Excellence, a Nevada Corporation

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC CENTER OF EXCELLENCE, A NEVADA CORPORATION

Doing business as

Hanger Clinic
Prosthetic Center of Excellence

Practice address

2047 W Charleston Blvd Ste 100
Las Vegas, NV 89102-2251

Phone

(702) 384-1410

Fax

(702) 384-0479

NPI assigned

Sep 30, 2005

Last updated

Nov 14, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

HANGER INCAs reported in NPPES

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

Authorized official

Name

Grace Angeline

Title

Provider Contract Analyst III

Phone

(714) 961-2102

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Hanger Clinic Doing business as
• Prosthetic Center of Excellence Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

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

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.

• Lesleigh B Sisson, CFOM

  • Orthotic Fitter
  • Las Vegas, NV
  • NPI 1588851828
  NPD

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1457348823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2047 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022251",
            "telephone_number": "702-384-1410",
            "fax_number": "702-384-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC CENTER OF EXCELLENCE, A NEVADA CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER INC",
        "enumeration_date": "2005-09-30",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "ANGELINE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "PROVIDER CONTRACT ANALYST III",
        "authorized_official_telephone_number": "714-961-2102"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003302169",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hanger Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prosthetic Center of Excellence",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prosthetic Center of Excellence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Prosthetic/Orthotic Supplier in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.