EVERGREEN PROSTHETICS AND ORTHOTICS, LLC
NPI 1619508702
Prosthetic/Orthotic Supplier in Meridian, ID

Q: What is Evergreen Prosthetics And Orthotics, LLC's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Active since January 28, 2020

1500 E HERITAGE PARK ST STE 100, MERIDIAN, ID 83646(208) 884-1294(208) 884-1293 Get Directions Write a Review

NPPES record last updated: November 22, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 22, 2023, Nov 1, 2023, Jan 28, 2020 (3 updates tracked since 2020).

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About Evergreen Prosthetics And Orthotics, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN PROSTHETICS AND ORTHOTICS, LLC (NPI 1619508702) is a healthcare organization registered as a prosthetic/orthotic supplier in Meridian, Idaho and active in the NPI registry since January 2020. The organization lists Timothy L O'neill, President, as its authorized official.

NPPES Registry Identity

NPI1619508702

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameEVERGREEN PROSTHETICS AND ORTHOTICS, LLC

Location Address1500 E HERITAGE PARK ST STE 100Meridian, ID 83646-5884

Mailing Address911 Main St Ste 100Oregon City, OR 97045-1853 · (503) 765-5081 · Fax (971) 316-1553

Phone(208) 884-1294

Fax(208) 884-1293

Organization SubpartNo

Authorized OfficialTimothy L O'neillPresident · (503) 407-5408

Enumeration DateJanuary 28, 2020

Last NPPES UpdateNovember 22, 20233 updates tracked since enumeration

NPPES CertifiedNovember 22, 2023

✔ NPI 1619508702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

Definition

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.

1500 E HERITAGE PARK ST STE 100, Meridian, ID 83646

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Medical Equipment Supplier Medicare DMEPOS 8

Medicare supplier enrollment and the product categories Evergreen Prosthetics And Orthotics carries, from the Medicare DMEPOS supplier directory.

Evergreen Prosthetics And Orthotics

DMEPOS supplier · Meridian, IDOperated by Evergreen Prosthetics And Orthotics LLC

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Does not accept Medicare assignment

Evergreen Prosthetics And Orthotics has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20331839

Medicare Participant SinceJanuary 1, 2023

Supplier Location1500 E Heritage Park St Ste 100Meridian, ID 83646

Phone(208) 884-1294

Supplier Specialties

Orthotic Personnel Prosthetic Personnel

Medicare Product Categories

Contracture Treatment Devices: Dynamic Splint

Dynamic splinting devices for the knee, elbow, wrist, finger, or toe

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

Surgical Dressings

Gauze, Elastic bandages, Adhesive tape

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Prosthetics And Orthotics, LLC's NPI number?

The NPI number for Evergreen Prosthetics And Orthotics, LLC is 1619508702. It was assigned to this organization in the NPPES registry on January 28, 2020.

Where is Evergreen Prosthetics And Orthotics, LLC located?

Evergreen Prosthetics And Orthotics, LLC is located at 1500 E Heritage Park St Ste 100, Meridian, ID 83646. The listed phone number is (208) 884-1294.

What is Evergreen Prosthetics And Orthotics, LLC's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Does Evergreen Prosthetics And Orthotics, LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Evergreen Prosthetics And Orthotics does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

When was this NPI record last updated?

The NPPES record for Evergreen Prosthetics And Orthotics, LLC was last updated on November 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.