Organization Active NPI

Rio Grande Orthotics and Prosthetics

  • Prosthetic/Orthotic Supplier
  • Santa Fe, NM
National Provider Identifier
1972680593
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
47951 Issued in NM
Legal business name
RIO GRANDE ORTHOTICS AND PROSTHETICS
Practice address
1691 Galisteo St
Suite B
Santa Fe, NM 87505-4780
Phone
(505) 820-2390
Fax
(505) 820-2392
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Mr. Forest Sexton
Title
Member
Phone
(541) 531-0439

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 47951 NM Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

1691 Galisteo St
Suite B
Santa Fe, NM 87505-4780

Mailing address

1691 Galisteo St
Suite B
Santa Fe, NM 87505-4780
Phone (505) 820-2390

Other identifiers 1

IdentifierTypeStateIssuer
84927054MedicaidNM

Other names 1

  • ADVANCED PROSTHETICS AND ORTHOTICS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930094386 NM DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 3678781937 Practice locations: Santa Fe, NM

Other NPIs with the same Medicare PAC ID 2

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
Advanced Prosthetics and Orthotic1691 Galisteo St, Santa Fe, NM 87505-4781(505) 820-2390 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Does not accept assignmentParticipating since Apr 7, 2004

National Provider Directory

National Provider Directory
Tax ID family
Rio Grande Orthotics and Prosthetics2 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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1972680593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-820-2390",
            "fax_number": "505-820-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 GALISTEO ST",
            "address_2": "SUITE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054780",
            "telephone_number": "505-820-2390",
            "fax_number": "505-820-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO GRANDE ORTHOTICS AND PROSTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "SEXTON",
        "authorized_official_first_name": "FOREST",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "541-531-0439",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NM",
            "license": "47951",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84927054",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED PROSTHETICS AND ORTHOTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.