NPIMap

Organization Active NPI

Pacific Medical, Inc.

Doing business as Pacific Medical Prosthetics & Orthotics

  • Prosthetic/Orthotic Supplier
  • Redding, CA
National Provider Identifier
1811223647
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
PACIFIC MEDICAL, INC.
Doing business as
Pacific Medical Prosthetics & Orthotics
Practice address
1760 Gold St
Suite 400
Redding, CA 96001-1806
Phone
(530) 229-0351
Fax
(530) 229-0386
NPI assigned
Oct 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Mark L Weaver, J.D.
Title
General Counsel
Phone
(800) 726-9180

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1760 Gold St
Suite 400
Redding, CA 96001-1806

Mailing address

File 1616
1801 W Olympic Blvd
Pasadena, CA 91199-1616
Phone (800) 726-9180

Other identifiers 1

IdentifierTypeStateIssuer
0695470001OtherCAMEDICARE

Other names 1

  • Pacific Medical Prosthetics & Orthotics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140619000408 CA DME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply Company 7416076732 Practice locations: Redding, CA

Other NPIs with the same Medicare PAC ID 22

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

View all 22

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
Pacific Medical Prosthetics & Ortho1760 Gold St, Redding, CA 96001-1806(530) 229-0351 Orthoses: Off-The-Shelf Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Pacific Medical Inc44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Member of 1

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

Locations

1760 Gold St
Ste 400
Redding, CA 96001
Phone (530) 229-0351

1301 Secret Ravine Pkwy
Roseville, CA 95661

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1811223647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 1616",
            "address_2": "1801 W OLYMPIC BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911991616",
            "telephone_number": "800-726-9180",
            "fax_number": "800-861-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 GOLD ST",
            "address_2": "SUITE 400",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011806",
            "telephone_number": "530-229-0351",
            "fax_number": "530-229-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-29",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "800-726-9180",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0695470001",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Medical Prosthetics & Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.