Prosthetic Solutions, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

CP003200 Issued in CA

Legal business name

PROSTHETIC SOLUTIONS, INC.

Practice address

3350 Scott Blvd
Suite 6301
Santa Clara, CA 95054-3109

Phone

(408) 845-9245

Fax

(408) 845-9259

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Wade Thomas Skardoutos, CPNPI 1346427069

Title

President

Phone

(408) 845-9245

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Prosthetic Solutions Inc.

  • Prosthetic/Orthotic Supplier
  • Hollister, CA
  • NPI 1447402599

  7517168289

  Same PAC ID

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

Tax ID family

Prosthetic Solutions Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Prosthetic Solutions Inc.

  • Prosthetic/Orthotic Supplier
  • Hollister, CA
  • NPI 1447402599
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wade Thomas Skardoutos, CP

  • Prosthetist
  • Santa Clara, CA
  • NPI 1346427069
  NPD Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1598858284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SCOTT BLVD",
            "address_2": "SUITE 6301",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950543109",
            "telephone_number": "408-845-9245",
            "fax_number": "408-845-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 SCOTT BLVD",
            "address_2": "SUITE 6301",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950543109",
            "telephone_number": "408-845-9245",
            "fax_number": "408-845-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "SKARDOUTOS",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-845-9245",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "CA",
            "license": "CP003200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U.S. DEPT OF LABOR",
            "identifier": "610058700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ66207Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "ZZZ66208Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla K. Prodany, MD
• Nicole Prodany, CRNA
• Professional Home Health Agency
• Mary Sullivan Prolo
• Seth Elliot Pross, MD
• Kimberly Marie Pruett, MD
• Jade Rae Prunella
• Alix J Pruzansky, MD
• PTR Sports, a Medical Corporation
• Victoria Dasalla Puntanilla, LVN

• Prosthetic/Orthotic Supplier in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.