Island Coast Orthopedics, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ISLAND COAST ORTHOPEDICS, INC.

Practice address

923 Del Prado Blvd S
#204
Cape Coral, FL 33990-3652

Phone

(239) 573-9003

Fax

(239) 573-7722

NPI assigned

Dec 28, 2006

Reactivated

Apr 18, 2016

Organization subpart

Yes

Parent organization

ISLAND COAST ORTHOPEDICS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Joshua RyderNPI 1629441258

Title

President

Phone

(239) 573-9003

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Island Coast O P2 organizations share this tax ID, including this one

Part of

Op Associates of Charlotte Cty Inc

Other organizations with this tax ID 1

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

• Island Coast O & P

  • Prosthetic/Orthotic Supplier
  • Cape Coral, FL
  • NPI 1932557485
  NPD tax ID

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua Ryder, CO

  • Prosthetist
  • Montague, MI
  • NPI 1629441258
  NPD Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1760548499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 DEL PRADO, #204",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902075",
            "telephone_number": "239-573-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 DEL PRADO BLVD S",
            "address_2": "#204",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903652",
            "telephone_number": "239-573-9003",
            "fax_number": "239-573-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND COAST ORTHOPEDICS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISLAND COAST ORTHOPEDICS, INC.",
        "enumeration_date": "2006-12-28",
        "last_updated": "2016-06-06",
        "deactivation_date": "2016-02-04",
        "reactivation_date": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "RYDER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-573-9003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Iriarte
• Yoel Iribarnegaray
• Tia Irminger, AUTONOMOUS APRN
• Isla Azul Senior Transport Corp
• Island Coast O & P
• Island Coast Pain & Rehabilitation Associates, Inc.
• Isw10244Delta Family Counseling
• It'S Vivace Expressive Therapy & More LLC
• Ivana Medical Equipment & Supplies Corp
• Daniel Izaguirre, DMD

• Prosthetic/Orthotic Supplier in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.