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MEDICAL CENTER ORTHOTICS AND PROSTHETICS LLC NPI 1336172196


NPI Information

NPI: 1336172196
Provider Name: MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC

Former Legal Business Name: SOUTH SHORE ORTHOPEDIC LABS INC

Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
199 REEDSDALE RD
MILTON, MA
ZIP 02186
Phone: (617) 698-6334
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MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC is a prosthetic orthotic supplier in Milton, MA. The provider is 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. MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC NPI is 1336172196. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is South Shore Orthopedic Labs Inc.

The provider's business location address is:

199 REEDSDALE RD
MILTON, MA
ZIP 02186
Phone: (617) 698-6334
Fax: (617) 698-3260

The provider's authorized official is Mike Corcoran .
The authorized official title is Ceo and has the following contact phone number (301) 585-5347.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 9/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1222Z00000XOrthotistNo
2225000000XOrthotic FitterNo
3335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1102441600OTHERMASSACHUSETTSUS DEPT OF LABOR PROV ID
2240254OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD ID
33137161OTHERMASSACHUSETTSCIGNA PROVIDER ID
4801088OTHERMASSACHUSETTSTUFTS HEALTH PLAN PROV ID
5800550OTHERMASSACHUSETTSHARVARD PILGRIM PROV ID
61501003MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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