NPIMap

Organization Active NPI

Mobility Prosthetic and Orthotic Services LLC

  • Prosthetic/Orthotic Supplier
  • Lake Havasu City, AZ
National Provider Identifier
1508528654
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MOBILITY PROSTHETIC AND ORTHOTIC SERVICES LLC
Practice address
1675 Mesquite Ave Ste a
Lake Havasu City, AZ 86403-5665
Phone
(928) 680-4089
Fax
(928) 680-0089
NPI assigned
Oct 6, 2021
Last updated
Aug 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Authorized official

Name
Rajiv RoyNPI 1952599979
Title
Clinical Director
Phone
(714) 390-7533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1675 Mesquite Ave Ste a
Lake Havasu City, AZ 86403-5665

Mailing address

1675 Mesquite Ave Ste a
Lake Havasu City, AZ 86403-5665
Phone (928) 680-4089

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251111000399 AZ DME Supplier - Certified Orth/Pros/Pedorthist 7214351477 Practice locations: Lake Havasu City, AZ

Other NPIs with the same Medicare PAC ID 2

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
Mobility Prosthetic & Orthotic Serv1675 Mesquite Ave, Lake Havasu City, AZ 86403-5665(928) 680-4089 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 Accepts assignmentParticipating since Jun 15, 2020

National Provider Directory

National Provider Directory
Tax ID family
Mobility Prosthetic and Orthotic Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1508528654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 MESQUITE AVE STE A",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035665",
            "telephone_number": "928-680-4089",
            "fax_number": "928-680-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 MESQUITE AVE STE A",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035665",
            "telephone_number": "928-680-4089",
            "fax_number": "928-680-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY PROSTHETIC AND ORTHOTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "RAJIV",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "714-390-7533"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.