PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC
NPI 1912303330
Prosthetic/Orthotic Supplier in Shreveport, LA
NPI Status: Active since November 12, 2014
Contact Information
3100 SAMFORD AVE
SHREVEPORT, LA
ZIP 71103
Phone: (318) 226-3310
Fax: (318) 226-4294
- Organization
- Prosthetic/Orthotic Supplier
- Accepts Insurance
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
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 Shreveport, Louisiana operating as a Prosthetic/orthotic Supplier. The healthcare provider is registered in the NPI registry with number 1912303330 assigned on November 2014. The practitioner's primary taxonomy code is 335E00000X. 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 Mr. Joseph Anthony Gomez Boco (Director Of O&p)
- NPI
- 1912303330
- Provider Name
- PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-SOUTHEAST, LLC
- Entity Type
- Organization
- Location Address
- 3100 SAMFORD AVE SHREVEPORT, LA 71103
- Location Phone
- (318) 226-3310
- Location Fax
- (318) 226-4294
- Mailing Address
- PO BOX 947109 ATLANTA, GA 30394
- Mailing Phone
- (318) 226-3310
- Mailing Fax
- (318) 226-4294
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 11-12-2014
- Last Update Date
- 04-23-2025
- Code Navigator
Pediatric Orthotic And Prosthetic Services-southeast, Llc is a medicare supplier with PTAN 20477891 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.
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
- 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:
- Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
- Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
- Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
- Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
- Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
- Blue Saver 60/40 $6100 - PPO
- Blue Saver 90/70 $3400 - PPO
- CHRISTUS Bronze (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze Essential - HMO
- CHRISTUS Bronze Essential (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze Essential + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Bronze Essential Plus - HMO
- CHRISTUS Catastrophic (3 Free PCP visits) - HMO
- CHRISTUS Gold - HMO
- CHRISTUS Gold + Dental & Vision + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold Essential - HMO
- CHRISTUS Gold Essential ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold Essential + Dental & Vision ($0 Rx Deductible, $5 PCP, $0 Virtual Urgent Care) - HMO
- CHRISTUS Gold Essential Plus - HMO
- CHRISTUS Gold Plus - HMO
- CHRISTUS Silver Essential - HMO
- CHRISTUS Silver Essential 70 ($5 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Silver Essential 70 + Dental & Vision ($5 PCP, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
- CHRISTUS Silver Essential Plus - HMO
- CHRISTUS Standard Expanded Bronze - HMO
- Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
- Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
- Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
- Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
- Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
- Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20477891
- 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
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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 1912303330, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
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 60 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SHREVEPORT, LA 71103
SHREVEPORT, LA 71103
SHREVEPORT, LA 71103
SHREVEPORT, LA 71103
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912303330, enumerated as an "organization" on November 12, 2014.
The provider is located at 3100 SAMFORD AVE SHREVEPORT, LA 71103 and the phone number is (318) 226-3310.
Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana, CHRISTUS. Please consult your insurance carrier or call the provider to verify.
