ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP.


Address: 6211 San Mateo Blvd Ne, Suite 150, Albuquerque, NM 87109-3533
Phone: 5059104174

ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP. (NPI# 1528506821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528506821
Entity Type Organization
Organization Name ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP.
Practice Address 6211 San Mateo Blvd Ne
Suite 150
Albuquerque
NM 87109-3533
Mailing Address 908 Poco Cerro Ct Se
Albuquerque
NM 87123-4193
Practice Telephone 5059104174
Mailing Telephone 8185216837
Enumeration Date 2017-02-07
Last Update Date 2020-01-10
Authorized Official Name DONALD DOTY (CLINICAL DIRECTOR)
Authorized Official Telephone 8185216837
Authorized Official Credential CPO
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 335E00000X Prosthetic/Orthotic Supplier Suppliers

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1285290437 Active Life Orthotics and Prosthetics Corp. Prosthetic/Orthotic Supplier 2515 N Kentucky Ave, Roswell, NM 88201-5807 2019-05-14

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP. 2515 N Kentucky Ave, Roswell, NM 88201-5807

Office Location

Street Address 6211 SAN MATEO BLVD NE
SUITE 150
City ALBUQUERQUE
State NM
Zip Code 87109-3533

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104973155 Richard J Vinnay Social Worker 6211 San Mateo Blvd Ne, Suite 170, Albuquerque, NM 87109-3533 2007-01-04
1396117321 Leslie Flager Mechanotherapist 6211 San Mateo Blvd Ne, Suite 200, Albuquerque, NM 87109-3533 2015-10-29
1083053839 The Medic Group, LLC Health Maintenance Organization 6211 San Mateo Blvd Ne, Albuquerque, NM 87109-3533 2013-06-14
1689970329 Mesa Behavioral Management, Inc. Counselor 6211 San Mateo Blvd Ne, Suite 170, Albuquerque, NM 87109-3533 2011-01-27
1548382039 Philip Jerome Tatoris Social Worker 6211 San Mateo Blvd Ne, Suite 170, Albuquerque, NM 87109-3533 2007-04-04

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386286367 Mikaela Epaloose Behavior Technician 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 2019-10-11
1245872464 Marsha Director Behavior Technician 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 2019-10-09
1720637499 Nancy Gail Vice Technician 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 2019-09-05
1598314411 Chau Vu Behavior Technician Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 2019-09-04
1932753498 Noelle Nielsen Behavior Technician 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 2019-08-01
1952967952 Caridad Merkel Obstetrics & Gynecology 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 2019-05-15
1043795149 Margaret Mcconville Physical Therapist Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 2018-09-25
1922586262 Clark Endodontics LLC Dentist 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 2018-07-30
1447736202 Melissa Christine Scott Registered Nurse Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 2018-07-16
1508351990 Gianna Nicole Casarez-quintana Dentist 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 2018-06-27
Find all providers in zip 87109

Taxonomy Information

Taxonomy Code 335E00000X
Grouping Suppliers
Classification Prosthetic/Orthotic Supplier

Taxonomy 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.
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700347358 Capitol Orthopedic Inc Prosthetic/Orthotic Supplier 401 Alvarado Dr Se Ste C, Albuquerque, NM 87108-2939 2019-03-27
1831653831 Rio Grande Orthotics and Prosthetics Prosthetic/Orthotic Supplier 4824 Mcmahon Blvd Nw Ste 112, Albuquerque, NM 87114-5412 2019-01-24
1336613298 Mid Star Lab Inc Prosthetic/Orthotic Supplier 401 Alvarado Dr Se, Albuquerque, NM 87108-2939 2019-01-14
1548679897 Functional Orthotics & Prosthetics Prosthetic/Orthotic Supplier 5111 Juan Tabo Blvd Ne Ste A, Albuquerque, NM 87111-2672 2014-08-11
1104187855 Lower Extremity International LLC Prosthetic/Orthotic Supplier 9428 Lexington Ave Ne Suite E, Albuquerque, NM 87112-1375 2012-05-30
1639488588 Estetica De Ella Salon (cranial Prosthesis) Prosthetic/Orthotic Supplier 2510 San Mateo Pl Ne, Albuquerque, NM 87110-4064 2010-09-27
1528276318 Albuquerque Orthotics & Prosthetics Prosthetic/Orthotic Supplier 4909 Ellison St Ne, Suite A, Albuquerque, NM 87109-4331 2007-05-18
1740236819 Active Life Inc Prosthetic/Orthotic Supplier 124 Alvarado Dr Se, Albuquerque, NM 87108-2940 2006-05-26
1902883473 Prosthetic Orthotic Specialists, Inc Prosthetic/Orthotic Supplier 5095 Ellison St Ne, Albuquerque, NM 87109-4326 2005-12-27
1891354197 Active Life Orthotics and Prosthetics Corp Prosthetic/Orthotic Supplier 124 Alvarado Dr Se, Albuquerque, NM 87108-2940 2019-06-10
Find all providers in ALBUQUERQUE

Competitor

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City ALBUQUERQUE
Zip Code 87109

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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