NPIMap

Organization Active NPI

Wellstart Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
National Provider Identifier
1104515402
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WELLSTART MEDICAL, LLC
Practice address
1745 S Alma School Rd Ste 210
Mesa, AZ 85210-3012
Phone
(800) 978-7599
Fax
(800) 971-3199
NPI assigned
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Brandon Beck
Title
Manager
Phone
(800) 978-7599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1745 S Alma School Rd Ste 210
Mesa, AZ 85210-3012

Mailing address

9156 S US Highway 1
Port St Lucie, FL 34952-3490
Phone (800) 978-7599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231023001222 AZ DME Supplier - Medical Supply Company 6709117310 Practice locations: Mesa, AZ

Other NPIs with the same Medicare PAC ID 3

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Wellstart Medical, LLC1745 S Alma School Rd, Mesa, AZ 85210-3012(800) 978-7599 Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order) Accepts assignmentParticipating since May 28, 2019

National Provider Directory

National Provider Directory
Tax ID family
Wellstart Medical LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1745 S Alma School Rd
Ste 210
Mesa, AZ 85210
Phone (800) 978-7599

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1104515402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9156 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523490",
            "telephone_number": "800-978-7599",
            "fax_number": "800-971-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 S ALMA SCHOOL RD STE 210",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103012",
            "telephone_number": "800-978-7599",
            "fax_number": "800-971-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTART MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "800-978-7599"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.