Prodigy Medical, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

991850 Issued in AK

Legal business name

PRODIGY MEDICAL, LLC

Practice address

4107 Hohe St
Homer, AK 99603-7008

Phone

(907) 226-3400

Fax

(907) 226-3300

NPI assigned

Jun 2, 2006

Last updated

Dec 30, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Berenice I Halpin

Title

Partner

Phone

(907) 299-3500

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

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).

• Prodigy Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Anchorage, AK
  • NPI 1912473885

  0446484372

  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

Prodigy Medical LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Prodigy Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Anchorage, AK
  • NPI 1912473885
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark D Halpin

  • Oxygen Equipment & Supplies (DME)
  • Homer, AK
  • NPI 1962765347
  NPD

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1073551131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 HOHE ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037008",
            "telephone_number": "907-226-3400",
            "fax_number": "907-226-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 HOHE ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037008",
            "telephone_number": "907-226-3400",
            "fax_number": "907-226-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "HALPIN",
        "authorized_official_first_name": "BERENICE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "907-299-3500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AK",
            "license": "991850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598711",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Poss
• Christine Masako Pratt, PA-C
• Premium Aspect Dentistry, LLC
• Jason D. Pretzel, LPC
• Preventive Dental Services, a Professional Corporation
• Lynn Marie Pura, NP
• Amy Raab
• Rain Or Shine Counseling, LLC
• Amy Rattenbury, L.AC.
• Paul D Raymond, MD

• Oxygen Equipment & Supplies (DME) in Homer, AK
• Providers in Homer, AK by specialty
• Oxygen Equipment & Supplies (DME) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.