NPIMap

Organization Active NPI

Brevard Prosthetics & Orthotics, Inc

  • Prosthetic/Orthotic Supplier
  • Melbourne, FL
National Provider Identifier
1467597450
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
BREVARD PROSTHETICS & ORTHOTICS, INC
Practice address
3040 N Wickham Rd Ste 7
Melbourne, FL 32935-2369
Phone
(321) 733-7778
Fax
(321) 638-4559
NPI assigned
Feb 20, 2007
Last updated
Sep 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Laura Allen
Title
Contracting Manager
Phone
(336) 482-8231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

3040 N Wickham Rd Ste 7
Melbourne, FL 32935-2369

Mailing address

PO Box 2300
Valparaiso, IN 46384-2300
Phone (219) 791-9200

Other names 1

  • Brevard Prosthetics, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930040755 FL DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 1557482445 Practice locations: Melbourne, FL

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Brevard Prosthetics & Orthotics Inc3040 N Wickham Rd, Melbourne, FL 32935-2369(321) 733-7778 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Brevard Prosthetics Orthotics Inc4 organizations share this tax ID, including this one
Part of
Brevard Prosthetics Orthotics Inc

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1405 Valentine St
Melbourne, FL 32901
Phone (321) 586-5001

3040 N Wickham Rd
Ste 14
Melbourne, FL 32935
Phone (321) 733-7778

3040 N Wickham Rd
Ste 7
Melbourne, FL 32935
Phone (321) 255-9546

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1467597450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2300",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463842300",
            "telephone_number": "219-791-9200",
            "fax_number": "312-268-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N WICKHAM RD STE 7",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352369",
            "telephone_number": "321-733-7778",
            "fax_number": "321-638-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREVARD PROSTHETICS & ORTHOTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CONTRACTING MANAGER",
        "authorized_official_telephone_number": "336-482-8231"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brevard Prosthetics, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.