PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-NORTHEAST,LLC (NPI# 1902208945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902208945 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-NORTHEAST,LLC |
| Practice Address |
516 Carew St Springfield MA 01104-2330 |
| Mailing Address |
Po Box 865109 Orlando FL 32886-5109 |
| Practice Telephone | 4137351223 |
| Practice Fax Number | 4137351214 |
| Mailing Telephone | 8446023960 |
| Mailing Fax Number | 8132818461 |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2015-06-09 |
| Authorized Official Name | ROBERT P. LOEFFLER (DIRECTOR OF O&P) |
| Authorized Official Telephone | 4137351223 |
| Authorized Official Credential | MS, CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | MA | Suppliers |
| Street Address |
516 CAREW ST |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01104-2330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861476798 | Philip William Mack | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104-2330 | 2005-12-05 |
| 1770014821 | Maureen Theresa Nahorniak | Physical Therapist | 516 Carew St, Springfield, MA 01104-2330 | 2017-03-21 |
| 1831638253 | David Joseph Kreps | Physical Therapist | 516 Carew St, Springfield, MA 01104-2330 | 2017-02-17 |
| 1699222695 | Keri Garry | Nurse Practitioner | 516 Carew St, Springfield, MA 01104-2330 | 2016-09-07 |
| 1154720027 | Rubini Pathy | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104-2330 | 2014-08-17 |
| 1285078444 | The Shriners' Hospital for Children | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104-2330 | 2013-04-18 |
| 1023360716 | Adam J Iwanski | Physician Assistant | 516 Carew St, Springfield, MA 01104-2330 | 2012-10-05 |
| 1942575147 | Ahmad Fouad Bayomy | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104 | 2012-03-20 |
| 1255633665 | Tammy L Sears-langevin | Nurse Practitioner | 516 Carew St, Springfield, MA 01104-2396 | 2010-11-18 |
| 1831304211 | Philip B Stoddard | Plastic Surgery | 516 Carew St, Shriners Hospital for Children, Springfield, MA 01104 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346727567 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2155 Main Street, Suite 131/133, Springfield, MA 01104 | 2018-07-20 |
| 1508385618 | Demetrios Sotiropoulos | Physician Assistant | 175 Carew St Ste 250, Springfield, MA 01104 | 2017-09-11 |
| 1114382942 | Rosana Rivera-delgado | Psychologist | 4017 Liberty St, Springfield, MA 01104 | 2015-12-21 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1437588837 | Ariam Ivette Pena | Counselor | 85 St. George Road, Springfield, MA 01104 | 2013-11-06 |
| 1891124293 | Ana E. Centeno | Counselor | 85 St. George Road., Springfield, MA 01104 | 2013-11-06 |
| 1275962003 | Swany Matos | Counselor | 2155 Main St., Springfield, MA 01104 | 2013-11-02 |
| 1184053910 | Claudia Eileen Quesada | Counselor | 2155 Main Street and St. George Road, The Gandara Center, Springfield, MA 01104 | 2013-11-02 |
| 1194023044 | Hungry Hill Family Practice | Clinic/Center | 776 Liberty Street, Hungry Hill Family Practice, Springfield, MA 01104 | 2011-03-02 |
| 1710115308 | Michael Allen Roche | Counselor | 332 Bernie Ave, Center for Human Development, Springfield, MA 01104 | 2009-06-23 |
| Find all providers in zip 01104 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
| 1205399029 | Tonee Jarrett | Prosthetic/Orthotic Supplier | 503 N Dirksen Pkwy, Springfield, IL 62702-6110 | 2019-04-09 |
| 1134636426 | Orthotics & Prosthetics Laboratories, Inc. | Prosthetic/Orthotic Supplier | 3500 Main St Ste 1, Springfield, MA 01107-1150 | 2018-01-08 |
| 1942638176 | Lester E Cox Medical Centers | Prosthetic/Orthotic Supplier | 2224 W Sunset St, Springfield, MO 65807-5980 | 2013-10-25 |
| 1245581131 | Lester E Cox Medical Centers | Prosthetic/Orthotic Supplier | 3525 S National Ave Ste 205b, Springfield, MO 65807-7315 | 2012-10-02 |
| 1720368509 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 2025 W Iles Ave Ste B, Springfield, IL 62704 | 2011-08-24 |
| 1154560647 | Z-coil Pain Relief Footwear | Prosthetic/Orthotic Supplier | 2674 S Glenstone Ave, Springfield, MO 65804-3718 | 2009-02-06 |
| 1235319260 | Bare Necessities of Springfield | Prosthetic/Orthotic Supplier | 1704 Boston Road, Springfield, MA 01129 | 2007-11-07 |
| 1811028087 | Kurt B. Fulk | Prosthetic/Orthotic Supplier | 2100 S Brentwood Blvd Ste A, Springfield, MO 65804-2534 | 2007-03-08 |
| 1205847787 | Cook's Orthopedics, Inc. | Prosthetic/Orthotic Supplier | 2012 Memorial Blvd, Springfield, TN 37172-3914 | 2006-08-10 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01104 |
Please comment or provide details below to improve the information on PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-NORTHEAST,LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.