Pediatric Orthotic and Prosthetic Services-Northeast,LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-NORTHEAST,LLC

Practice address

516 Carew St
Springfield, MA 01104-2330

Phone

(413) 735-1223

Fax

(413) 735-1214

NPI assigned

Sep 22, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Brock McConkey, MS, CPO

Title

Manager

Phone

(413) 735-1223

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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 - Northeast, LLC

  • Prosthetic/Orthotic Supplier
  • Erie, PA
  • NPI 1992175459

  1951617950

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

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
  • NPI 1336537042

  1951617950

  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 - Northeast LLC3 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 - Northeast, LLC

  • Prosthetic/Orthotic Supplier
  • Erie, PA
  • NPI 1992175459
  NPD tax ID
• Pediatric Orthotic and Prosthetic Services- Northeast, LLC

  • Prosthetic/Orthotic Supplier
  • Philadelphia, PA
  • NPI 1336537042
  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

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1902208945",
    "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": "813-367-2876",
            "fax_number": "813-518-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 CAREW ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042330",
            "telephone_number": "413-735-1223",
            "fax_number": "413-735-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-NORTHEAST,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "MCCONKEY",
        "authorized_official_first_name": "BROCK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "413-735-1223",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela J Peck, NP
• Elizabeth Pecoy-Whitcomb, P.A.
• Pediatric Care Associates, P.C.
• Pediatric Gastroenterology & Nutrition of Western Ma
• Pediatric Gastroenterology and Nutrition Group, P.C.
• Pediatric Pulmonology of Western New England, P.C.
• Pediatric Surgical Services, Inc
• Kimberly A Pedigo, PA-C
• Yolanda Pedraza
• Gretchen Peery

• Prosthetic/Orthotic Supplier in Springfield, MA
• Providers in Springfield, MA by specialty
• Prosthetic/Orthotic Supplier in Massachusetts

• 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.