Organization Active NPI

Elite Equipment and Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Austin, TX
National Provider Identifier
1699522326
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ELITE EQUIPMENT AND SUPPLIES LLC
Practice address
314 E Highland Mall Blvd Ste 102
Austin, TX 78752-3701
Phone
(512) 379-8074
Fax
(512) 379-8074
NPI assigned
May 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Khalil Shafiq
Title
Authorized Official
Phone
(512) 379-8074

Specialties & licenses 1

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

Addresses

Primary practice location

314 E Highland Mall Blvd Ste 102
Austin, TX 78752-3701

Mailing address

314 E Highland Mall Blvd Ste 102
Austin, TX 78752-3701
Phone (512) 379-8074

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240730002762 TX DME Supplier - Medical Supply Company 2163969940 Practice locations: Austin, TX

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
Elite Equipment and Supplies LLC314 E Highland Mall Blvd, Austin, TX 78752-3701(512) 379-8074 Automatic Ext Defibrillator (AEDS) and/or Supplies|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Hospital Beds (Electric)|Hospital Beds (Manual)|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Ultraviolet … Does not accept assignmentParticipating since Jun 7, 2024

National Provider Directory

National Provider Directory

Locations

314 E Highland Mall Blvd
Ste 102
Austin, TX 78752
Phone (512) 379-8074

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1699522326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E HIGHLAND MALL BLVD STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523701",
            "telephone_number": "512-379-8074",
            "fax_number": "512-379-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E HIGHLAND MALL BLVD STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523701",
            "telephone_number": "512-379-8074",
            "fax_number": "512-379-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EQUIPMENT AND SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "SHAFIQ",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "512-379-8074"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.