Organization Active NPI

Peterman Orthotics & Prosthetics LLC

Doing business as Advanced Limb & Brace

  • Prosthetic/Orthotic Supplier
  • Amarillo, TX
National Provider Identifier
1699772046
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
588 Issued in TX
Legal business name
PETERMAN ORTHOTICS & PROSTHETICS LLC
Doing business as
Advanced Limb & Brace
Practice address
4 Medical Dr Ste B
Amarillo, TX 79106-4166
Phone
(806) 351-1775
Fax
(806) 351-1754
NPI assigned
Jun 30, 2005
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HANGER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Grace Angeline
Title
Provider Contract Analyst III
Phone
(714) 961-2102

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Prosthetic/Orthotic Supplier 335E00000X 215 TX
Prosthetic/Orthotic Supplier 335E00000X 404 TX
Prosthetic/Orthotic Supplier 335E00000X 591 TX
Prosthetic/Orthotic Supplier 335E00000X 101169 TX
Prosthetic/Orthotic Supplier 335E00000X NU
Prosthetic/Orthotic Supplier 335E00000X 588 TX Primary

Addresses

Primary practice location

4 Medical Dr Ste B
Amarillo, TX 79106-4166

Mailing address

PO Box 650846
Dallas, TX 75265-0846

Other names 1

  • Advanced Limb & Brace Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930073012 TX DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 2769693654 Practice locations: Amarillo, TX

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
Advance Limb and Brace4 Medical Dr, Amarillo, TX 79106-4166(806) 351-1775 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Jan 1, 2012

National Provider Directory

National Provider Directory
Tax ID family
Advanced Limb Brace2 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.

Locations

4 Medical Dr
Ste B
Amarillo, TX 79106
Phone (806) 351-1775

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1699772046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650846",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEDICAL DR STE B",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064166",
            "telephone_number": "806-351-1775",
            "fax_number": "806-351-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERMAN ORTHOTICS & PROSTHETICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HANGER INC",
        "enumeration_date": "2005-06-30",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "ANGELINE",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "PROVIDER CONTRACT ANALYST III",
        "authorized_official_telephone_number": "714-961-2102"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "215",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "404",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "591",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "101169",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Limb & Brace",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Limb & Brace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.