NPIMap

Organization Active NPI

Coastalorthopedic Center, Inc.

  • Prosthetic/Orthotic Supplier
  • Okeechobee, FL
National Provider Identifier
1992143614
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
PRO84 Issued in FL
Legal business name
COASTALORTHOPEDIC CENTER, INC.
Practice address
710 NW Park St
Okeechobee, FL 34972-4155
Phone
(863) 357-0079
Fax
(772) 336-4040
NPI assigned
Jun 5, 2013
Last updated
Jun 5, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
COASTALORTHOPEDIC CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Joseph Perretta, C.P.NPI 1356497234
Title
Owner
Phone
(772) 871-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X PRO84 FL Primary

Addresses

Primary practice location

710 NW Park St
Okeechobee, FL 34972-4155

Mailing address

510 SW Port St Lucie Blvd
Port St Lucie, FL 34953-1943
Phone (772) 871-9200

Other identifiers 1

IdentifierTypeStateIssuer
200996001MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Coastal Orthopedic Center Inc5 organizations share this tax ID, including this one
Part of
Coastal Orthopedic Center Inc

Other organizations with this tax ID 4

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

Locations

710 NW Park St
Okeechobee, FL 34972
Phone (863) 357-0079

510 SW Port St Lucie Blvd
Port St Lucie, FL 34953
Phone (772) 871-9200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1992143614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531943",
            "telephone_number": "772-871-9200",
            "fax_number": "772-336-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NW PARK ST",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349724155",
            "telephone_number": "863-357-0079",
            "fax_number": "772-336-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTALORTHOPEDIC CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTALORTHOPEDIC CENTER, INC.",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "PERRETTA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-871-9200",
        "authorized_official_credential": "C.P."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "PRO84",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200996001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.