Deluxe Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DELUXE MEDICAL SUPPLY LLC

Practice address

4240 Latham St Ste E
Riverside, CA 92501-1741

Phone

(619) 741-5901

Fax

(619) 741-5910

NPI assigned

Feb 4, 2025

Organization subpart

Yes

Parent organization

DELUXE MEDICAL SUPPLY LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yerken Tenizbayev

Title

Managing Member

Phone

(619) 741-5901

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Deluxe Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • La Mesa, CA
  • NPI 1801183272

  4688849979

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Deluxe Medical Supply LLC3 organizations share this tax ID, including this one

Part of

Deluxe Medical Supply LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Deluxe Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • La Mesa, CA
  • NPI 1801183272
  NPD tax ID
• Deluxe Medical Supply, LLC

  • Durable Medical Equipment & Medical Supplies
  • National City, CA
  • NPI 1538980479
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Deluxe Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • La Mesa, CA
  • NPI 1801183272
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1003620683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427420",
            "telephone_number": "619-741-5901",
            "fax_number": "619-741-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 LATHAM ST STE E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011741",
            "telephone_number": "619-741-5901",
            "fax_number": "619-741-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELUXE MEDICAL SUPPLY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELUXE MEDICAL SUPPLY LLC",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "TENIZBAYEV",
        "authorized_official_first_name": "YERKEN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "619-741-5901"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon A Delle Donne, DPT
• Danielle Deloatch
• Elizabeth Delong, RADTI
• Dawnyelle Delongchamp, LEP#4577
• Elizabeth Martha Delrio
• Nathaniel Demarco
• Fadi Demian, DMD
• Kasielee Demonaco
• Eli Brian Denham, P.T.
• Amanda Dennett

• Durable Medical Equipment & Medical Supplies in Riverside, CA
• Providers in Riverside, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.