Presque Isle Orthotics and Prosthetics of Ohio, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PRESQUE ISLE ORTHOTICS AND PROSTHETICS OF OHIO, LLC

Practice address

718 Horton Dr
Silver Spring, MD 20902-3009

Phone

(301) 681-8658

Fax

(866) 536-2954

NPI assigned

Mar 5, 2013

Organization subpart

Yes

Parent organization

PRESQUE ISLE ORTHOTICS AND PROSTHETICS OF OHIO, LLCAs reported in NPPES

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

Authorized official

Name

Solomon Heifetz

Title

Director of Operations

Phone

(301) 681-8658

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Presque Isle Medical Technologies Doing business as

Tax ID family

Presque Isle Orthotics and Prosthetics of Ohio LLC3 organizations share this tax ID, including this one

Part of

Presque Isle Orthotics and Prosthetics of Ohio LLC

Other organizations with this tax ID 2

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

• Presque Isle Orthotics and Prosthetics of Ohio, LLC

  • Prosthetic/Orthotic Supplier
  • South Euclid, OH
  • NPI 1871840447
  NPD tax ID
• Presque Isle Orthotics and Prosthetics of Ohio, LLC

  • Prosthetic/Orthotic Supplier
  • Skokie, IL
  • NPI 1912307992
  NPD tax ID

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620604800000",
    "number": "1669713467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 RICHMOND RD STE 1000",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441221390",
            "telephone_number": "216-371-0660",
            "fax_number": "866-536-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 HORTON DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209023009",
            "telephone_number": "301-681-8658",
            "fax_number": "866-536-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESQUE ISLE ORTHOTICS AND PROSTHETICS OF OHIO, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESQUE ISLE ORTHOTICS AND PROSTHETICS OF OHIO, LLC",
        "enumeration_date": "2013-03-05",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A",
        "authorized_official_last_name": "HEIFETZ",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "301-681-8658"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052595200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presque Isle Medical Technologies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Prosthetic/Orthotic Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.