ORTHOTIC & PROSTHETIC CENTER OF BRADENTON – Prosthetic/Orthotic Supplier, NPI 1417112822

ORTHOTIC & PROSTHETIC CENTER OF BRADENTON is a healthcare provider. based in St petersburg, Florida. specializing in Prosthetic/Orthotic Supplier. The organization holds a License No. POR 101 (FL). The NPI Number for ORTHOTIC & PROSTHETIC CENTER OF BRADENTON is 1417112822

Main info

Organization
Name
ORTHOTIC & PROSTHETIC CENTER OF BRADENTON
NPI
1417112822
Phone
(727) 327-3332
Address
3611 5TH AVE N
Authorized Official
CHRISTINA GELAZNIK DIRECTOR OF FINANCE & OPERATIONS
Enumeration Date
24 July 2008
Last Update Date
15 November 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness80
Years active:17State licenses:2Digital endpointsUpdated within 12 months

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Provider Addresses for ORTHOTIC & PROSTHETIC CENTER OF BRADENTON

  • 5th Avenue North, Saint Petersburg, Pinellas County, Florida, 33701, United States

    ST PETERSBURG, FL 337137503

    Phone: (727) 327-3332

    Fax: (727) 327-7304

    Type: Mailing

  • 101, Manatee Avenue East, Bradenton, Manatee County, Florida, 34208, United States

    BRADENTON, FL 342081620

    Phone: (941) 751-6100

    Fax: (941) 751-6199

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-09-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-06-30 (709 days ago).

Enrollment records

1

Earliest due date

2024-06-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20150909003361OCertified Orth/Pros/PedorthistFL2024-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33713)

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Reviews

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Frequently asked questions

Does ORTHOTIC & PROSTHETIC CENTER OF BRADENTON share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ORTHOTIC & PROSTHETIC CENTER OF BRADENTON uses 1417112822.
Is ORTHOTIC & PROSTHETIC CENTER OF BRADENTON listed as active for patients and plans?
The listing shows ORTHOTIC & PROSTHETIC CENTER OF BRADENTON as active in the NPI system.
What is ORTHOTIC & PROSTHETIC CENTER OF BRADENTON's primary classification?
Prosthetic/Orthotic Supplier is the headline specialty for ORTHOTIC & PROSTHETIC CENTER OF BRADENTON here. Clinical services aligned with this taxonomy classification.
What address line appears for ORTHOTIC & PROSTHETIC CENTER OF BRADENTON?
ORTHOTIC & PROSTHETIC CENTER OF BRADENTON's geographic hint is St Petersburg, Florida in our summary view.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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