Organization Active NPI

Performance Modalities, Inc.

Doing business as Performance Home Medical

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
National Provider Identifier
1801085071
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
601 488 099 Issued in WA
Legal business name
PERFORMANCE MODALITIES, INC.
Doing business as
Performance Home Medical
Practice address
1802 Yakima Ave Ste 200
Tacoma, WA 98405-4499
Phone
(866) 687-4463
Fax
(877) 414-2727
NPI assigned
Oct 23, 2007
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, NAC
Title
Director of Compliance
Phone
(206) 569-4601

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 601 488 099 WA Primary
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

1802 Yakima Ave Ste 200
Tacoma, WA 98405-4499

Mailing address

19625 62ND Ave S Ste A101
Kent, WA 98032-1106
Phone (866) 687-4463

Other identifiers 1

IdentifierTypeStateIssuer
1055116MedicaidWA

Other names 1

  • Performance Home Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930067672 WA DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 6608996616 Practice locations: Tacoma, WA

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 Home Medical1802 Yakima Ave, Tacoma, WA 98405-4499(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 Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Member of 2

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

Locations

705 S 9th St
Ste 103
Tacoma, WA 98405
Phone (253) 272-5466

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1801085071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19625 62ND AVE S STE A101",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980321106",
            "telephone_number": "866-687-4463",
            "fax_number": "877-414-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054499",
            "telephone_number": "866-687-4463",
            "fax_number": "877-414-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE MODALITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "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",
        "authorized_official_credential": "NAC"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WA",
            "license": "601 488 099",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1055116",
            "state": "WA"
        }
    ],
    "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 Tacoma, WA

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.