Active NPI
Rio Grande Orthotics and Prosthetics
- Prosthetic/Orthotic Supplier
- Santa Fe, NM
National Provider Identifier
1972680593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 47951
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84927054 | Medicaid | NM |
Other names 1
- ADVANCED PROSTHETICS AND ORTHOTICS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930094386 | NM | DME Supplier - Prosthetic 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).
-
- Prosthetic/Orthotic Supplier
- Albuquerque, NM
- NPI 1578009296
3678781937
-
- Prosthetic/Orthotic Supplier
- Albuquerque, NM
- NPI 1831653831
3678781937
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Advanced Prosthetics and Orthotic | 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 assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Rio Grande Orthotics and Prosthetics
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- Albuquerque, NM
- NPI 1578009296
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.