Vital Peak Medical Supplies LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

VITAL PEAK MEDICAL SUPPLIES LLC

Practice address

10000 N 31St Ave Ste 100-133
Phoenix, AZ 85051-9582

Phone

(833) 340-7037

NPI assigned

Mar 20, 2024

Last updated

Jan 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hazem J Atiya

Title

Owner

Phone

(833) 340-7037

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1508626177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 N 31ST AVE STE C100-133",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511395",
            "telephone_number": "951-651-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 N 31ST AVE STE 100-133",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850519582",
            "telephone_number": "833-340-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PEAK MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "ATIYA",
        "authorized_official_first_name": "HAZEM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "833-340-7037"
    },
    "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": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Prosthetic/Orthotic Supplier in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.