Specialty Medical Products, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

6000005931 Issued in PA

Legal business name

SPECIALTY MEDICAL PRODUCTS, INC.

Practice address

3 Pennsylvania Ave
Malvern, PA 19355-2417

Phone

(610) 644-1370

Fax

(610) 644-3992

NPI assigned

Dec 22, 2006

Last updated

Feb 4, 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

Audrey Ellis

Title

Billing

Phone

(610) 644-1370

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1740345537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PENNSYLVANIA AVE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193552417",
            "telephone_number": "610-644-1370",
            "fax_number": "610-644-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PENNSYLVANIA AVE",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193552417",
            "telephone_number": "610-644-1370",
            "fax_number": "610-644-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY MEDICAL PRODUCTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "610-644-1370"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "PA",
            "license": "6000005931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018842500001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008338",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ryan Daniel Staudle, PSY.D.
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• Nena Oglesby Stetson, LCSW
• Steven S Shapiro, PH.D., LLC
• Edward B Stier, MA, ATC

• Customized Equipment (DME) in Malvern, PA
• Providers in Malvern, PA by specialty
• Customized Equipment (DME) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.