Organization Active NPI

Stance Prosthetics & Orthotics LLC

  • Prosthetic/Orthotic Supplier
  • Santa Ana, CA
National Provider Identifier
1629350178
Registry record updated Oct 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
STANCE PROSTHETICS & ORTHOTICS LLC
Practice address
1125 E 17TH St Ste N354
Santa Ana, CA 92701-2269
Phone
(714) 852-3756
Fax
(714) 852-3856
NPI assigned
Sep 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2022

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

Authorized official

Name
Kenneth TemekiNPI 1720260474
Title
Member/Owner LLC
Phone
(714) 852-3756

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

1125 E 17TH St Ste N354
Santa Ana, CA 92701-2269

Mailing address

1125 E 17TH St Ste N354
Santa Ana, CA 92701-2269
Phone (714) 852-3756

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120423000148 CA DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 9335300177 Practice locations: Santa Ana, CA

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
Gardena Valley Medical Center1125 E 17TH St, Santa Ana, CA 92701-2269(714) 852-3756 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Limb Prostheses|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Feb 24, 2012

National Provider Directory

National Provider Directory

Locations

1300 W 155th St
Ste 106
Gardena, CA 90247
Phone (310) 358-4596

Practitioners & affiliated clinicians

Practitioners 1

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": "1315699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664668800000",
    "number": "1629350178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST STE N354",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012269",
            "telephone_number": "714-852-3756",
            "fax_number": "714-852-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST STE N354",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012269",
            "telephone_number": "714-852-3756",
            "fax_number": "714-852-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANCE PROSTHETICS & ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-11",
        "last_updated": "2022-10-02",
        "certification_date": "2022-10-02",
        "status": "A",
        "authorized_official_last_name": "TEMEKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER/OWNER LLC",
        "authorized_official_telephone_number": "714-852-3756"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.