NPIMap

Organization Active NPI

Jefferson Orthopedics Inc

  • Customized Equipment (DME)
  • Metairie, LA
National Provider Identifier
1669435129
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
435810 Issued in LA
Legal business name
JEFFERSON ORTHOPEDICS INC
Practice address
1612 Clearview Pkwy
Metairie, LA 70001
Phone
(504) 888-0213
Fax
(504) 888-0293
NPI assigned
Apr 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Brittany Grunberg, CP-CERTIFIED ORTHOTI
Title
Owner
Phone
(504) 888-0213

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 435810 LA Primary
Prosthetic/Orthotic Supplier 335E00000X 435810 LA

Addresses

Primary practice location

1612 Clearview Pkwy
Metairie, LA 70001

Mailing address

1612 Clearview Pkwy
Metairie, LA 70001
Phone (504) 888-0213

Other identifiers 1

IdentifierTypeStateIssuer
1118231MedicaidLA

Other names 1

  • Prosthetic & Orthotic Associates of Louisianna Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930076040 LA DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Pedorthic PersonnelDME Supplier - Medical Supply Company With Pedorthic PersonnelDME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Orthotic Personnel 5294852463 Practice locations: Metairie, LA

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
Prosthetic & Orthotic Associates of1612 Clearview Pkwy, Metairie, LA 70001-3427(504) 888-0213 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

Locations

1612 Clearview Pkwy
Metairie, LA 70001
Phone (504) 888-0213

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1669435129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 CLEARVIEW PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70001",
            "telephone_number": "504-888-0213",
            "fax_number": "504-888-0293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 CLEARVIEW PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70001",
            "telephone_number": "504-888-0213",
            "fax_number": "504-888-0293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON ORTHOPEDICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "GRUNBERG",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-888-0213",
        "authorized_official_credential": "CP-CERTIFIED ORTHOTI"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "LA",
            "license": "435810",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "LA",
            "license": "435810",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1118231",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosthetic & Orthotic Associates of Louisianna",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.