Organization Active NPI

National Prosthetic Orthotic Associates, Inc

  • Prosthetic/Orthotic Supplier
  • Bayside, NY
National Provider Identifier
1720063555
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
P-1113 Issued in NY
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01115099MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930037678 NY DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 4385761758 Practice locations: Bayside, NY

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.