Evergreen Prosthetics and Orthotics, LLC
NPI 1619508702 · Prosthetic/Orthotic Supplier · Meridian, ID
Enrolled with Medicare as Dme Supplier - Orthotic Personnel · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Evergreen Prosthetics and Orthotics, LLC is a Prosthetic/Orthotic Supplier organization in Meridian, ID (NPI 1619508702).
Provider details
- NPI number
- 1619508702
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Timothy O'Neill, President(503) 407-5408
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-01-28
- Last updated
- 2023-11-22
- Certified
- 2023-11-22
Frequently asked questions
- What is Evergreen Prosthetics and Orthotics, LLC's NPI number?
- Evergreen Prosthetics and Orthotics, LLC's National Provider Identifier (NPI) is 1619508702, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Evergreen Prosthetics and Orthotics, LLC?
- Evergreen Prosthetics and Orthotics, LLC is classified in the NPPES registry as Prosthetic/Orthotic Supplier (Suppliers).
- Where is Evergreen Prosthetics and Orthotics, LLC located?
- Evergreen Prosthetics and Orthotics, LLC's practice location on file with NPPES is 1500 E Heritage Park St Ste 100, Meridian, ID 83646-5884.
- What is Evergreen Prosthetics and Orthotics, LLC's phone number?
- The practice phone number listed in the NPPES registry for Evergreen Prosthetics and Orthotics, LLC is (208) 884-1294.
- Does Evergreen Prosthetics and Orthotics, LLC accept Medicare?
- Evergreen Prosthetics and Orthotics, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Evergreen Prosthetics and Orthotics, LLC?
- The authorized official listed on Evergreen Prosthetics and Orthotics, LLC's NPPES record is Timothy O'Neill, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Evergreen Prosthetics and Orthotics, LLC's NPI active?
- Yes — Evergreen Prosthetics and Orthotics, LLC's NPI (1619508702) is active in the NPPES registry as of the last update on 2023-11-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.