Active NPI
National Prosthetic Orthotic Associates, Inc
- Prosthetic/Orthotic Supplier
- Bayside, NY
National Provider Identifier
1720063555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- P-1113
- Legal business name
- NATIONAL PROSTHETIC ORTHOTIC ASSOCIATES, INC
- Practice address
- 21441 42ND Ave
3Rd Floor
Bayside, NY 11361-2963 - Phone
- (718) 423-8700
- Fax
- (718) 423-8708
- NPI assigned
- Dec 14, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Fernando Onel Perez, PROSTHETIST
- Title
- President
- Phone
- (718) 423-8700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | P-1113 | NY | Primary |
Addresses
Primary practice location
21441 42ND Ave
3Rd Floor
Bayside, NY 11361-2963
Mailing address
21441 42ND Ave
3Rd Floor
Bayside, NY 11361-2963
Phone (718) 423-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01115099 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930037678 | NY | DME Supplier - Prosthetic Personnel | 4385761758 | Practice locations: Bayside, NY |
National Provider Directory
National Provider DirectoryLocations
21441 42nd Ave
Ste 3A
Bayside, NY 11361
21441 42nd Ave
Fl 3
Bayside, NY 11361
Phone (718) 423-8700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1720063555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21441 42ND AVE",
"address_2": "3RD FLOOR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113612963",
"telephone_number": "718-423-8700",
"fax_number": "718-423-8708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21441 42ND AVE",
"address_2": "3RD FLOOR",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113612963",
"telephone_number": "718-423-8700",
"fax_number": "718-423-8708"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONAL PROSTHETIC ORTHOTIC ASSOCIATES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PEREZ",
"authorized_official_first_name": "FERNANDO",
"authorized_official_middle_name": "ONEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-423-8700",
"authorized_official_credential": "PROSTHETIST"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "NY",
"license": "P-1113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01115099",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.