NPIMap

Organization Active NPI

Pacific Medical, Inc.

  • Customized Equipment (DME)
  • Burien, WA
National Provider Identifier
1114661253
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
Legal business name
PACIFIC MEDICAL, INC.
Practice address
275 SW 160TH St Ste 110
Burien, WA 98166-3003
Phone
(206) 241-2786
Fax
(206) 241-3349
NPI assigned
Apr 25, 2022
Last updated
Apr 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PACIFIC MEDICAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Mark Weaver
Title
General Counsel/C.L.O.
Phone
(800) 723-9180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Customized Equipment (DME) 332BC3200X NU Primary

Addresses

Primary practice location

275 SW 160TH St Ste 110
Burien, WA 98166-3003

Mailing address

1700 N Chrisman Rd
Tracy, CA 95304-9314
Phone (800) 726-9180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230327000338 WA DME Supplier - Medical Supply Company With Orthotic-Prosthetic 7416076732 Practice locations: Burien, WA

Other NPIs with the same Medicare PAC ID 22

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

View all 22

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
Pacific Medical, Inc.275 SW 160TH St, Burien, WA 98166-3006(425) 226-5922 Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Pacific Medical Inc44 organizations share this tax ID, including this one
Part of
Pacific Medical Inc

Other organizations with this tax ID 43

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

View all 43

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1114661253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N CHRISMAN RD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953049314",
            "telephone_number": "800-726-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SW 160TH ST STE 110",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663003",
            "telephone_number": "206-241-2786",
            "fax_number": "206-241-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC MEDICAL, INC.",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "GENERAL COUNSEL/C.L.O.",
        "authorized_official_telephone_number": "800-723-9180"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.