NPIMap

Organization Active NPI

Orthotic & Prosthetic Solutions LLC

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
National Provider Identifier
1962014100
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
ORTHOTIC & PROSTHETIC SOLUTIONS LLC
Practice address
1050 N Flowood Dr Ste B4
Jackson, MS 39232-9738
Phone
(769) 777-7440
Fax
(985) 256-2599
NPI assigned
Aug 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Dandre Shondale Mostella
Title
Owner
Phone
(256) 458-6071

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1744P3200X
OrthotistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 222Z00000X
ProsthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 224P00000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1050 N Flowood Dr Ste B4
Jackson, MS 39232-9738

Mailing address

7754 Florida Blvd
Baton Rouge, LA 70806-4706
Phone (225) 243-9736

Other identifiers 1

IdentifierTypeStateIssuer
1143OtherMS1143

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.orthoticprostheticssolutions.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200824000608 MS DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 2769803071 Practice locations: Flowood, MS

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Orthotic & Prosthetic Solutions LLC1050 N Flowood Dr, Flowood, MS 39232-9738(769) 777-7440 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since May 5, 2020

National Provider Directory

National Provider Directory
Tax ID family
Orthotic Prosthetic Solutions LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1050 N Flowood Dr
Ste B24
Flowood, MS 39232

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1962014100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7754 FLORIDA BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708064706",
            "telephone_number": "225-243-9736",
            "fax_number": "985-256-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 N FLOWOOD DR STE B4",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329738",
            "telephone_number": "769-777-7440",
            "fax_number": "985-256-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOTIC & PROSTHETIC SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "MOSTELLA",
        "authorized_official_first_name": "DANDRE",
        "authorized_official_middle_name": "SHONDALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-458-6071"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1143",
            "identifier": "1143",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.orthoticprostheticssolutions.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3670 Lakeland Ln # B-4",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.