Organization Active NPI

Otto Bock Patient Care, LLC

  • Prosthetic/Orthotic Supplier
  • Mechanicsburg, PA
National Provider Identifier
1487367108
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
OTTO BOCK PATIENT CARE, LLC
Practice address
2005 Technology Pkwy Ste 200
Mechanicsburg, PA 17050-9413
Phone
(717) 458-8429
NPI assigned
Dec 27, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Pallavi Nemani
Title
Compliance Officer
Phone
(512) 552-6311

Corporate family (same tax ID) 7

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230503000520 PA DME Supplier - Certified Orth/Pros/PedorthistDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 2668804667 Practice locations: Mechanicsburg, PA

National Provider Directory

National Provider Directory
Tax ID family
Otto Bock Patient Care LLC (57 organizations share this tax ID)

Locations

2005 Technology Pkwy
Ste 200
Mechanicsburg, PA 17050
Phone (717) 458-8429

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

2005 Technology Pkwy Ste 200
Mechanicsburg, PA 17050-9413

Mailing address

11809 Domain Dr Unit 100
Austin, TX 78758-3452

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 27, 2022.

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1487367108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 DOMAIN DR UNIT 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 TECHNOLOGY PKWY STE 200",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170509413",
            "telephone_number": "717-458-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTO BOCK PATIENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "NEMANI",
        "authorized_official_first_name": "PALLAVI",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "512-552-6311"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.