Organization Active NPI

Orthopedic Appliances of Central New York, Inc.

  • Prosthetic/Orthotic Supplier
  • Syracuse, NY
National Provider Identifier
1538228440
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ORTHOPEDIC APPLIANCES OF CENTRAL NEW YORK, INC.
Practice address
507 East Fayette Street
Syracuse, NY 13202-1951
Phone
(315) 474-2464
Fax
(315) 474-2465
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. James N Hettler, C.O.
Title
President
Phone
(315) 474-2464

Specialties & licenses 1

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

Addresses

Primary practice location

507 East Fayette Street
Syracuse, NY 13202-1951

Mailing address

507 East Fayette Street
Syracuse, NY 13202-1951
Phone (315) 474-2464

Other identifiers 1

IdentifierTypeStateIssuer
00569746MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930019885 NY DME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company 3173640471 Practice locations: Syracuse, NY

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
Orthopedic Appliances of Central NE507 E Fayette St, Syracuse, NY 13202-1921(315) 474-2464 Heat & Cold Applications|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 Jan 5, 1999

National Provider Directory

National Provider Directory

Locations

507 E Fayette St
Syracuse, NY 13202
Phone (315) 474-2464

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538228440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 EAST FAYETTE STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132021951",
            "telephone_number": "315-474-2464",
            "fax_number": "315-474-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 EAST FAYETTE STREET",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132021951",
            "telephone_number": "315-474-2464",
            "fax_number": "315-474-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC APPLIANCES OF CENTRAL NEW YORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HETTLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-474-2464",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.O."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00569746",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.