Pro Fit Prosthetics and Orthotics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

45PO00015100 Issued in NJ

Legal business name

PRO FIT PROSTHETICS AND ORTHOTICS LLC

Practice address

901 Route 168
Suite 410
Turnersville, NJ 08012

Phone

(856) 374-8006

Fax

(856) 374-0169

NPI assigned

Nov 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Edward Dalsey, CPO FAAOP

Title

Owner

Phone

(856) 374-8006

Specialties & licenses 1

Addresses

Other identifiers 7

Tax ID family

Pro Fit Prosthetics and Orthotics LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pro-Fit LLC

  • Prosthetic/Orthotic Supplier
  • West Berlin, NJ
  • NPI 1780873083
  NPD tax ID

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952488470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 ROUTE 168",
            "address_2": "SUITE 410",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-374-8006",
            "fax_number": "856-374-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ROUTE 168",
            "address_2": "SUITE 410",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-374-8006",
            "fax_number": "856-374-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO FIT PROSTHETICS AND ORTHOTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DALSEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-374-8006",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO FAAOP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NJ",
            "license": "45PO00015100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8664609",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH GROUP",
            "identifier": "0005171000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "64577",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0005171000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2657725",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "117308",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K1903",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Turnersville, NJ
• Providers in Turnersville, NJ by specialty
• Prosthetic/Orthotic Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.