NPIMap

Organization Active NPI

Duramed, Inc.

  • Oxygen Equipment & Supplies (DME)
  • Kenner, LA
National Provider Identifier
1710923255
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
DURAMED, INC.
Practice address
1015 24TH St
Kenner, LA 70062-5268
Phone
(504) 467-4057
Fax
(504) 467-4053
NPI assigned
Jun 22, 2006
Last updated
Jan 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Authorized official

Name
Mr. Ricky Walter Decastro Sr.
Title
President/Owner
Phone
(504) 467-4057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X LA Primary

Addresses

Primary practice location

1015 24TH St
Kenner, LA 70062-5268

Mailing address

1015 24TH St
Kenner, LA 70062-5268
Phone (504) 467-4057

Other identifiers 2

IdentifierTypeStateIssuer
1669814MedicaidLA
B6939OtherLABCBS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930015091 LA DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 5496875999 Practice locations: Kenner, LA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Duramed Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1710923255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 24TH ST",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700625268",
            "telephone_number": "504-467-4057",
            "fax_number": "504-467-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 24TH ST",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700625268",
            "telephone_number": "504-467-4057",
            "fax_number": "504-467-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURAMED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "DECASTRO",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "504-467-4057",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669814",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "B6939",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.