NPIMap

Organization Active NPI

Pacific Medical, Inc.

Doing business as Pacific Medical Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Richland, WA
National Provider Identifier
1164654935
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PACIFIC MEDICAL, INC.
Doing business as
Pacific Medical Prosthetics & Orthotics
Practice address
969 Stevens Dr
Suites 2a & 2C
Richland, WA 99352-3525
Phone
(509) 371-9660
Fax
(509) 371-9662
NPI assigned
Aug 12, 2009
Last updated
Feb 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Authorized official

Name
Mark Weaver, JD
Title
General Counsel
Phone
(800) 726-9180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Prosthetic/Orthotic Supplier 335E00000X NU Primary

Addresses

Primary practice location

969 Stevens Dr
Suites 2a & 2C
Richland, WA 99352-3525

Mailing address

File 1616
1801 W Olympic Blvd
Pasadena, CA 91199-1616
Phone (800) 726-9180

Other identifiers 1

IdentifierTypeStateIssuer
0695470001OtherMEDICARE PROVIDER NUMBER

Other names 1

  • Pacific Medical Prosthetics & Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150123001669 WA DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company 7416076732 Practice locations: Richland, 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 Prosthetics & Ortho969 Stevens Dr, Richland, WA 99352-3525(509) 371-9660 Continuous Passive Motion (CPM) Devices|Heat & Cold Applications|Osteogenesis Stimulators|Canes and/or Crutches|Walkers|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymp… 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

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": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1164654935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 1616",
            "address_2": "1801 W OLYMPIC BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911991616",
            "telephone_number": "800-726-9180",
            "fax_number": "800-861-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 STEVENS DR",
            "address_2": "SUITES 2A & 2C",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523525",
            "telephone_number": "509-371-9660",
            "fax_number": "509-371-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "800-726-9180",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "0695470001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Medical Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.