Organization Active NPI

Preferred Prosthetics Inc

  • Prosthetic/Orthotic Supplier
  • Lodi, CA
National Provider Identifier
1619243763
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PREFERRED PROSTHETICS INC
Practice address
1300 W Lodi Ave
Suite H
Lodi, CA 95242-3000
Phone
(209) 625-8450
Fax
(209) 224-8416
NPI assigned
Mar 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Authorized official

Name
Steven Charles VeraNPI 1154577484
Title
Owner
Phone
(209) 625-8450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1300 W Lodi Ave
Suite H
Lodi, CA 95242-3000

Mailing address

1300 W Lodi Ave
Suite H
Lodi, CA 95242-3000
Phone (209) 625-8450

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200331002540 CA DME Supplier - Certified Orth/Pros/Pedorthist 8921288929 Practice locations: Lodi, CA

Other NPIs with the same Medicare PAC ID 1

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
Preferred Prosthetics Inc.1300 W Lodi Ave, Lodi, CA 95242-3037(209) 625-8450 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Dec 27, 2010

National Provider Directory

National Provider Directory
Tax ID family
Preferred Prosthetics Inc3 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.

Locations

1740 Marco Polo Way
Ste 10
Burlingame, CA 94010
Phone (408) 358-9741

1300 W Lodi Ave
Ste H
Lodi, CA 95242
Phone (209) 625-8450

7600 Hospital Dr
Ste G2
Sacramento, CA 95823
Phone (916) 896-5702

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1619243763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE",
            "address_2": "SUITE H",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423000",
            "telephone_number": "209-625-8450",
            "fax_number": "209-224-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE",
            "address_2": "SUITE H",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423000",
            "telephone_number": "209-625-8450",
            "fax_number": "209-224-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "VERA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-625-8450"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.