NPIMap

Organization Active NPI

Deluxe Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • La Mesa, CA
National Provider Identifier
1801183272
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DELUXE MEDICAL SUPPLY LLC
Practice address
7474 El Cajon Blvd
La Mesa, CA 91942-7420
Phone
(619) 741-5901
Fax
(619) 741-5910
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Authorized official

Name
Mr. Yerken Tenizbayev
Title
Ceo
Phone
(619) 741-5901

Specialties & licenses 2

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

Addresses

Primary practice location

7474 El Cajon Blvd
La Mesa, CA 91942-7420

Mailing address

7474 El Cajon Blvd
La Mesa, CA 91942-7420
Phone (619) 741-5901

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111215000230 CA DME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Oxygen & Equipment 4688849979 Practice locations: La Mesa, CA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Deluxe Medical Supply LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7950 University Ave
La Mesa, CA 91942

4240 Latham St
Ste E
Riverside, CA 92501
Phone (619) 741-5901

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1801183272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427420",
            "telephone_number": "619-741-5901",
            "fax_number": "619-741-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7474 EL CAJON BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427420",
            "telephone_number": "619-741-5901",
            "fax_number": "619-741-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELUXE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "TENIZBAYEV",
        "authorized_official_first_name": "YERKEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-741-5901",
        "authorized_official_name_prefix": "Mr."
    },
    "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": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.