PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLC
NPI 1386929347
Prosthetic/Orthotic Supplier in Tampa, FL
NPI Status: Active since October 20, 2011
Contact Information
15511 N FLORIDA AVE STE 102
TAMPA, FL
ZIP 33613
Phone: (813) 975-7139
Fax: (813) 631-7160
- Organization
- Prosthetic/Orthotic Supplier
- Accepts Insurance
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 10D1089693
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 03-12-2026
About PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLC
This page provides the complete NPI Profile along with additional information for Pediatric Orthotic And Prosthetic Services - Southeast, Llc, a provider established in Tampa, Florida operating as a Prosthetic/orthotic Supplier. The healthcare provider is registered in the NPI registry with number 1386929347 assigned on October 2011. The practitioner's primary taxonomy code is 335E00000X with license number 4184 (FL). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Ms. Joanne Kanas (Executive Director O&p)
- NPI
- 1386929347
- Provider Name
- PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES - SOUTHEAST, LLC
- Entity Type
- Organization
- Location Address
- 15511 N FLORIDA AVE STE 102 TAMPA, FL 33613
- Location Phone
- (813) 975-7139
- Location Fax
- (813) 631-7160
- Mailing Address
- PO BOX 947109 ATLANTA, GA 30394
- Mailing Phone
- (813) 367-2876
- Mailing Fax
- (813) 631-7160
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 10-20-2011
- Last Update Date
- 09-25-2025
- Code Navigator
Pediatric Orthotic And Prosthetic Services - Southeast, Llc is a medicare supplier with PTAN 20477885 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Orthoses: Custom Fabricated or Orthoses: Prefabricated (Non-Custom Fabricated) or Orthoses: Off-The-Shelf or Limb Prostheses or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom or Lymphedema Compression Treatment Items.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Prosthetic/Orthotic Supplier
- Taxonomy Code
- 335E00000X
- Type
- Suppliers
- License No.
- 4184
- License State
- FL
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete VALUE Gold - HMO
- Focused VALUE Silver - HMO
- Focused VALUE Silver + Vision + Adult Dental - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Standard Silver VALUE + Vision + Adult Dental - HMO
- Clarity Silver - HMO
- Clarity VALUE Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete VALUE Gold - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite VALUE Bronze - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 004604300 | MEDICAID (05) | FL |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20477885
- Accepts Medicare Assignment
- NO
- Specialities List
- MSC With Orthotic Personnel, MSC With Prosthetic Personnel, MSC With Orthotic-Prosthetic, Orthotic Personnel, Prosthetic Personnel.
- Competitive Bidding
- NO
Supplies List
- Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
- Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Limb Prostheses - Prosthetic arms, Prosthetic feet, Prosthetic knees
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
- Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
- Lymphedema Compression Treatment Items -
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D1089693
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- March 13, 2024
- Certificate Expiration Date
- March 12, 2026
- Laboratory Director
- DR. WILFREDO CHAMIZO
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Pediatric Orthotic And Prosthetic Services - Southeast, Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1386929347, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386929347, enumerated as an "organization" on October 20, 2011.
The provider is located at 15511 N FLORIDA AVE STE 102 TAMPA, FL 33613 and the phone number is (813) 975-7139.
Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.
The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.
