Active NPI
Jason Todd Friedman, C.P.O.
- Prosthetic/Orthotic Supplier
- Poway, CA
National Provider Identifier
1881870285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- CPO1661
- Practice address
- 15644 Pomerado Rd
Suite 103
Poway, CA 92064-2400 - Phone
- (858) 613-0958
- Fax
- (858) 613-0959
- NPI assigned
- Jan 15, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | CPO1661 | CA | Primary |
Addresses
Primary practice location
15644 Pomerado Rd
Suite 103
Poway, CA 92064-2400
Mailing address
15644 Pomerado Rd
Suite 103
Poway, CA 92064-2400
Phone (858) 613-0958
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GXC000850 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPO1661 | CA | MD | Prosthetic/Orthotic Supplier |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J & J Artificial Limb & Brace LLC | Prosthetic/Orthotic Supplier | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Prosthetic/Orthotic Supplier
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- NPI 1508911173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277337600000",
"number": "1881870285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15644 POMERADO RD",
"address_2": "SUITE 103",
"city": "POWAY",
"state": "CA",
"postal_code": "920642400",
"telephone_number": "858-613-0958",
"fax_number": "858-613-0959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15644 POMERADO RD",
"address_2": "SUITE 103",
"city": "POWAY",
"state": "CA",
"postal_code": "920642400",
"telephone_number": "858-613-0958",
"fax_number": "858-613-0959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIEDMAN",
"first_name": "JASON",
"middle_name": "TODD",
"credential": "C.P.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-15",
"last_updated": "2010-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "CA",
"license": "CPO1661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GXC000850",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.