NPIMap

Organization Active NPI

Pacific Medical, Inc.

Doing business as Pacific Medical Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Modesto, CA
National Provider Identifier
1386892529
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
609 E Orangeburg Ave
Suite 102
Modesto, CA 95350-5512
Phone
(209) 526-1721
Fax
(209) 526-1740
NPI assigned
Aug 29, 2008
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 L. 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

609 E Orangeburg Ave
Suite 102
Modesto, CA 95350-5512

Mailing address

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

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
O20140121001721 CA DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company 7416076732 Practice locations: Modesto, 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 Prosthetics & Ortho609E Orangeburg Ave 102, Modesto, CA 95350-5512(209) 526-1721 Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Com… 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

609 E Orangeburg Ave
Ste 102
Modesto, CA 95350
Phone (209) 526-1721

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1386892529",
    "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": "609 E ORANGEBURG AVE",
            "address_2": "SUITE 102",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505512",
            "telephone_number": "209-526-1721",
            "fax_number": "209-526-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L.",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Medical Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

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.