NPIMap

Organization Active NPI

Rio Grande Orthotics and Prosthetics

Doing business as Advanced Prosthetics and Orthotics

  • Prosthetic/Orthotic Supplier
  • Albuquerque, NM
National Provider Identifier
1578009296
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
COM-2016-341856 Issued in NM
Legal business name
RIO GRANDE ORTHOTICS AND PROSTHETICS
Doing business as
Advanced Prosthetics and Orthotics
Practice address
1010 Lead Ave SE
Ste 400
Albuquerque, NM 87106-5214
Phone
(505) 247-0430
Fax
(505) 247-0653
NPI assigned
Jan 19, 2017
Organization subpart
Yes
Parent organization
RIO GRANDE ORTHOTICS AND PROSTHETICS DBA ADVANCED PROSTHETICS AND ORTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Forest Sexton
Title
Member
Phone
(541) 531-0439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X COM-2016-341856 NM Primary

Addresses

Primary practice location

1010 Lead Ave SE
Ste 400
Albuquerque, NM 87106-5214

Mailing address

1010 Lead Ave SE
Ste 400
Albuquerque, NM 87106-5214
Phone (505) 247-0430

Other identifiers 1

IdentifierTypeStateIssuer
38400839MedicaidNM

Other names 1

  • Advanced Prosthetics and Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170802001940 NM DME Supplier - Certified Orth/Pros/Pedorthist 3678781937 Practice locations: Albuquerque, NM

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
Rio Grande Orthotics and Prosthetic1010 Lead Ave SE, Albuquerque, NM 87106-5214(505) 247-0430 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 Apr 7, 2004

National Provider Directory

National Provider Directory
Tax ID family
Rio Grande Orthotics and Prosthetics2 organizations share this tax ID, including this one
Part of
Rio Grande Orthotics and Prosthetics

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1578009296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 LEAD AVE SE",
            "address_2": "STE 400",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065214",
            "telephone_number": "505-247-0430",
            "fax_number": "505-247-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LEAD AVE SE",
            "address_2": "STE 400",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065214",
            "telephone_number": "505-247-0430",
            "fax_number": "505-247-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO GRANDE ORTHOTICS AND PROSTHETICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIO GRANDE ORTHOTICS AND PROSTHETICS DBA ADVANCED PROSTHETICS AND ORTH",
        "enumeration_date": "2017-01-19",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "SEXTON",
        "authorized_official_first_name": "FOREST",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "541-531-0439"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NM",
            "license": "COM-2016-341856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38400839",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Prosthetics and Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.