One Source Medical Group LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ONE SOURCE MEDICAL GROUP LLC

Practice address

4848 Perrin CRK Ste 680
San Antonio, TX 78217-3744

Phone

(866) 834-7473

Fax

(877) 490-9111

NPI assigned

Apr 24, 2012

Organization subpart

Yes

Parent organization

ONE SOURCE MEDICAL GROUP LLCAs reported in NPPES

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

Authorized official

Name

Daniel J Jonathan Robichaud

Title

Ceo

Phone

(866) 834-7473

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• One Source Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1366653545

  5597960930

  Same PAC ID
• One Source Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Savannah, GA
  • NPI 1902369267

  5597960930

  Same PAC ID

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

Tax ID family

One Source Medical Group LLC3 organizations share this tax ID, including this one

Part of

One Source Medical Group LLC

Other organizations with this tax ID 2

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

• One Source Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1366653545
  NPD tax ID
• One Source Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Savannah, GA
  • NPI 1902369267
  NPD tax ID

Locations

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1841558160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13910 LYNMAR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336263123",
            "telephone_number": "866-834-7473",
            "fax_number": "877-490-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 PERRIN CRK STE 680",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173744",
            "telephone_number": "866-834-7473",
            "fax_number": "877-490-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ONE SOURCE MEDICAL GROUP LLC",
        "enumeration_date": "2012-04-24",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "ROBICHAUD",
        "authorized_official_first_name": "DANIEL J",
        "authorized_official_middle_name": "JONATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-834-7473"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311694901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.