Active NPI
O&P Clinical Technologies Inc
- Prosthetic/Orthotic Supplier
- Gainesville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- POR56
- Legal business name
- O&P CLINICAL TECHNOLOGIES INC
- Practice address
- 4650 NW 39TH Ave Ste G
Gainesville, FL 32606-6090 - Phone
- (352) 331-4221
- Fax
- (352) 332-8074
- NPI assigned
- Dec 3, 2007
- 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
- Paul Edward Prusakowski, LPO, CPO, FAAOP
- Title
- President/Ceo
- Phone
- (352) 331-4221
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | POR56 | FL | |
| Prosthetic/Orthotic Supplier | 335E00000X | POR56 | FL | Primary |
Addresses
Primary practice location
4650 NW 39TH Ave Ste G
Gainesville, FL 32606-6090
Mailing address
4650 NW 39TH Ave Ste G
Gainesville, FL 32606-6090
Phone (352) 331-4221
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000849796O | Other | ABC | |
| 6MYL2 | Other | CAGE | |
| NB7TG45GY7L5 | Other | SAM | |
| 952053800 | Medicaid | FL |
Other names 1
- Gainesville Prosthetics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930002948 | FL | DME Supplier - Prosthetic Personnel | 5496876096 | Practice locations: Gainesville, FL |
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| O&P Clinical Technologies Inc | Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items | Does not accept assignment |
National Provider Directory
National Provider DirectoryLocations
4650 NW 39th Pl
Ste G
Gainesville, FL 32606
4650 NW 39th Ave
Ste G
Gainesville, FL 32606
Phone (352) 331-4221
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Prosthetist
- Gainesville, FL
- NPI 1144895152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773273600000",
"number": "1871775668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 NW 39TH AVE STE G",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326066090",
"telephone_number": "352-331-4221",
"fax_number": "352-332-8074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 NW 39TH AVE STE G",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326066090",
"telephone_number": "352-331-4221",
"fax_number": "352-332-8074"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "O&P CLINICAL TECHNOLOGIES INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-03",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A",
"authorized_official_last_name": "PRUSAKOWSKI",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "352-331-4221",
"authorized_official_credential": "LPO, CPO, FAAOP"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "FL",
"license": "POR56",
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "FL",
"license": "POR56",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ABC",
"identifier": "000849796O",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAGE",
"identifier": "6MYL2",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAM",
"identifier": "NB7TG45GY7L5",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "952053800",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gainesville Prosthetics",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Gainesville Prosthetics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.