Organization Active NPI

O&P Clinical Technologies Inc

  • Prosthetic/Orthotic Supplier
  • Gainesville, FL
National Provider Identifier
1871775668
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
POR56 Issued in FL
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

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Paul Edward Prusakowski, LPO, CPO, FAAOPNPI 1720079775
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000849796OOtherABC
6MYL2OtherCAGE
NB7TG45GY7L5OtherSAM
952053800MedicaidFL

Other names 1

  • Gainesville Prosthetics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930002948 FL DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 5496876096 Practice locations: Gainesville, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
O&P Clinical Technologies Inc4650 NW 39TH Ave, Gainesville, FL 32606-6090(352) 331-4221 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 assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.