Pediatric Orthotic and Prosthetic Services-West, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-WEST, LLC

Practice address

2425 Stockton Blvd
Suite 236
Sacramento, CA 95817-2215

Phone

(916) 453-2170

Fax

(916) 453-5024

NPI assigned

Apr 20, 2010

Organization subpart

No

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

Authorized official

Name

Michael Wadekamper

Title

Manager

Phone

(916) 453-2170

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pediatric Orthotic and Prosthetic Services-West,LLC

  • Prosthetic/Orthotic Supplier
  • Pasadena, CA
  • NPI 1043613821

  6103139860

  Same PAC ID
• Pediatric Orthotic and Prosthetic Services- West, LLC

  • Prosthetic/Orthotic Supplier
  • Salt Lake City, UT
  • NPI 1225430150

  6103139860

  Same PAC ID

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

Tax ID family

Pediatric Orthotic and Prosthetic Services-Westllc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Pediatric Orthotic and Prosthetic Services-West,LLC

  • Prosthetic/Orthotic Supplier
  • Pasadena, CA
  • NPI 1043613821
  NPD tax ID
• Pediatric Orthotic and Prosthetic Services- West, LLC

  • Prosthetic/Orthotic Supplier
  • Salt Lake City, UT
  • NPI 1225430150
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Shriners Hospitals for Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1316065360

  Member Of

  NPD member

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pediatric Orthotic and Prosthetic Services-West,LLC

  • Prosthetic/Orthotic Supplier
  • Pasadena, CA
  • NPI 1043613821
  NPPES parent name

Practitioners 2

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

• Richard Lyman Wilcox, CP

  • Prosthetist
  • Sacramento, CA
  • NPI 1780964999
  NPD (past)
• Leslie Douglas Stewart, MD

  • Surgery Physician
  • Memphis, TN
  • NPI 1902874282
  NPD (past)

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1811213549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947109",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947109",
            "telephone_number": "916-453-2170",
            "fax_number": "916-453-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "address_2": "SUITE 236",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "916-453-2170",
            "fax_number": "916-453-5024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-WEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "WADEKAMPER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-453-2170"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Himaja Peddi, M.D.
• Nigel Paul Pedersen, M.D.
• Pediatric Bioscience, Inc.
• Pediatric Cardiologists of Northern California Inc
• Pediatric Medical Associates of Sacramento Inc
• Pediatric Urgent Care of Sacramento, Inc
• Pediatric Urology Medical Group, Inc.
• Pediatrix Cardiology of Sacramento PC
• Kenneth Pedigo
• Diego Timoteo Pedraza

• Prosthetic/Orthotic Supplier in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.