Impakt Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IMPAKT MEDICAL LLC

Practice address

1811 Santa Rita Rd Ste 202
Pleasanton, CA 94566-4741

Phone

(916) 844-7800

Fax

(916) 436-9054

NPI assigned

Mar 19, 2024

Organization subpart

No

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

Authorized official

Name

Bryant P Majernik

Title

Vice President

Phone

(916) 844-7800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

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

• Impakt Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • San Mateo, CA
  • NPI 1093529463

  1759626476

  Same PAC ID
• Impakt Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Los Gatos, CA
  • NPI 1376143479

  1759626476

  Same PAC ID
• Impakt Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Santa Cruz, CA
  • NPI 1417429648

  1759626476

  Same PAC ID
• Impakt Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Fair Oaks, CA
  • NPI 1992299838

  1759626476

  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

Impakt Medical LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Impakt Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • San Mateo, CA
  • NPI 1093529463
  NPD tax ID
• Impakt Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Los Gatos, CA
  • NPI 1376143479
  NPD tax ID
• Impakt Medical, LLC

  • Durable Medical Equipment & Medical Supplies
  • Santa Cruz, CA
  • NPI 1417429648
  NPD tax ID
• Impakt Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Fair Oaks, CA
  • NPI 1992299838
  NPD tax ID

Locations

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1306606231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9722 FAIR OAKS BLVD STE B",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287039",
            "telephone_number": "916-844-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 SANTA RITA RD STE 202",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945664741",
            "telephone_number": "916-844-7800",
            "fax_number": "916-436-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPAKT MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "MAJERNIK",
        "authorized_official_first_name": "BRYANT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "916-844-7800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Pleasanton, CA
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.