NPIMap

Organization Active NPI

Performance Modalities Inc

Doing business as Performance Home Medical

  • Durable Medical Equipment & Medical Supplies
  • Coeur d'Alene, ID
National Provider Identifier
1639791734
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PERFORMANCE MODALITIES INC
Doing business as
Performance Home Medical
Practice address
1110 W Park PL Ste 308
Coeur D Alene, ID 83814-2715
Phone
(866) 687-4463
Fax
(877) 414-2727
NPI assigned
May 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Luana Michele Hall
Title
Director of Compliance
Phone
(206) 569-4601

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

1110 W Park PL Ste 308
Coeur D Alene, ID 83814-2715

Mailing address

PO Box 94307
Seattle, WA 98124-6607
Phone (253) 372-5530

Other names 1

  • Performance Home Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200706001718 ID DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 6608996616 Practice locations: Coeur D Alene, ID

Other NPIs with the same Medicare PAC ID 20

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

View all 20

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
Performance Modalities Inc1110 W Park PL, Coeur D Alene, ID 83814-2715(866) 687-4463 Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Tracheotomy Supplies|Continuous Positive Airway Pressure (CPAP) Devices|High Freq Chest Wall Oscillation Devices/Supplies|Intermittent Positive Pressure Breathing IPPB DEV|Intrapulmonary Percussive Ventila… Does not accept assignmentParticipating since Jan 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Performance Modalities Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

19625 62nd Ave S
Ste 101
Kent, WA 98032

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1639791734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94307",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246607",
            "telephone_number": "253-372-5530",
            "fax_number": "253-854-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 308",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142715",
            "telephone_number": "866-687-4463",
            "fax_number": "877-414-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE MODALITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "LUANA",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "206-569-4601"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Home Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Performance Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.