NPIMap

Organization Active NPI

Pacific Medical, Inc.

Doing business as Pacific Medical Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Tracy, CA
National Provider Identifier
1326048893
Registry record updated Aug 9, 2013
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
1700 N. Chrisman Road
Tracy, CA 95304-9314
Phone
(800) 726-9180
Fax
(800) 861-5950
NPI assigned
Jul 27, 2005
Last updated
Aug 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Authorized official

Name
Mark Louis Weaver, J.D.
Title
General Counsel/C.O.O.
Phone
(800) 726-9180

Specialties & licenses 2

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

Addresses

Primary practice location

1700 N. Chrisman Road
Tracy, CA 95304-9314

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
DME01767GMedicaidCA

Other names 1

  • Pacific Medical Prosthetics & Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930048970 CA DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic-Prosthetic 7416076732 Practice locations: Tracy, CA

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 Inc1700 N Chrisman Rd, Tracy, CA 95304-9314(800) 726-9180 Negative Pressure Wound Therapy Pumps/Supplies|Neuromuscular Elect Stimulators (NMES)/Supplies|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatm… 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.

Locations

969 Stevens Dr
Richland, WA 99352

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1326048893",
    "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": "1700 N. CHRISMAN ROAD",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953049314",
            "telephone_number": "800-726-9180",
            "fax_number": "800-861-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-27",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "GENERAL COUNSEL/C.O.O.",
        "authorized_official_telephone_number": "800-726-9180",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME01767G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Medical Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.