Advanced Pedorthics, LLC.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

03836323 Issued in MD

Legal business name

ADVANCED PEDORTHICS, LLC.

Practice address

5411 Old Frederick Rd Ste 10
Baltimore, MD 21229-2126

Phone

(443) 844-6395

Fax

(410) 788-7785

NPI assigned

Sep 17, 2014

Last updated

Sep 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Goldman, CETIFIED PEDORTHISTNPI 1013345610

Title

Owner

Phone

(443) 844-6395

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Goldman, C. PED

  • Pedorthist
  • Baltimore, MD
  • NPI 1013345610
  NPD Authorized official
• Sheldon Tajerstein, DPM

  • Podiatrist
  • Baltimore, MD
  • NPI 1073688750
  NPD (past)

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1790187110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 OLD FREDERICK RD SUITE 10",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21229",
            "telephone_number": "443-844-6395",
            "fax_number": "410-788-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 OLD FREDERICK RD STE 10",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292126",
            "telephone_number": "443-844-6395",
            "fax_number": "410-788-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PEDORTHICS, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-844-6395",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CETIFIED PEDORTHIST"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MD",
            "license": "03836323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Baltimore, MD
• Providers in Baltimore, 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 Sep 2, 2020; 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.