NPIMap

Organization Active NPI

Orthotic & Prosthetic Centers, Inc.

Doing business as Orthotic & Prosthetic Center of Port St Lucie

  • Prosthetic/Orthotic Supplier
  • Port St Lucie, FL
National Provider Identifier
1568872190
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
POR 101 Issued in FL
Legal business name
ORTHOTIC & PROSTHETIC CENTERS, INC.
Doing business as
Orthotic & Prosthetic Center of Port St Lucie
Practice address
1781 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5479
Phone
(772) 249-3033
Fax
(772) 448-8379
NPI assigned
May 5, 2014
Last updated
Nov 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Authorized official

Name
Christina Gelaznik
Title
Director of Finance & Operations
Phone
(727) 498-1003

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X FL
Customized Equipment (DME) 332BC3200X FL
Prosthetic/Orthotic Supplier 335E00000X POR 101 FL Primary

Addresses

Primary practice location

1781 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5479

Mailing address

3611 5TH Ave N
St Petersburg, FL 33713-7503
Phone (727) 327-3332

Other identifiers 1

IdentifierTypeStateIssuer
016782400MedicaidFL

Other names 1

  • ORTHOTIC & PROSTHETIC CENTER OF PORT ST LUCIE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150210001744 FL DME Supplier - Certified Orth/Pros/PedorthistDME Supplier - Medical Supply Company With Orthotic-Prosthetic 0840319570 Practice locations: Port St Lucie, FL

Other NPIs with the same Medicare PAC ID 20

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

View all 20

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
Orthotic & Prosthetic Center of Por1781 SE Port St Lucie Blvd, Port St Lucie, FL 34952-5479(772) 249-3033 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
Orthotic Prosthetic Centers Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1568872190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137503",
            "telephone_number": "727-327-3332",
            "fax_number": "727-327-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525479",
            "telephone_number": "772-249-3033",
            "fax_number": "772-448-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC & PROSTHETIC CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "GELAZNIK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE & OPERATIONS",
        "authorized_official_telephone_number": "727-498-1003"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "POR 101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016782400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORTHOTIC & PROSTHETIC CENTER OF PORT ST LUCIE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.