Organization Active NPI

Prodigy Medical, LLC

  • Oxygen Equipment & Supplies (DME)
  • Anchorage, AK
National Provider Identifier
1912473885
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
PRODIGY MEDICAL, LLC
Practice address
3000 A St Ste 405
Anchorage, AK 99503-4040
Phone
(907) 444-8876
Fax
(907) 782-4208
NPI assigned
Oct 18, 2018
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Mark D HalpinNPI 1962765347
Title
Ceo
Phone
(907) 226-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X NU
Oxygen Equipment & Supplies (DME) 332BX2000X NU Primary

Addresses

Primary practice location

3000 A St Ste 405
Anchorage, AK 99503-4040

Mailing address

4107 Hohe St
Homer, AK 99603-7008
Phone (907) 226-3400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190619002114 AK DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 0446484372 Practice locations: Anchorage, AK

Other NPIs with the same Medicare PAC ID 1

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

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
Anchorage3000 A St, Anchorage, AK 99503-4040(907) 444-8876 Continuous Positive Airway Pressure (CPAP) Devices|Nebulizer Equipment and/or Supplies|Oxygen Equipment and/or Supplies|Respiratory Assist Devices Does not accept assignmentParticipating since Aug 12, 2013

National Provider Directory

National Provider Directory
Tax ID family
Prodigy Medical LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

205 E Benson Blvd
Ste 116
Anchorage, AK 99503

3000 A St
Ste 405
Anchorage, AK 99503
Phone (907) 444-8876

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1912473885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 HOHE ST",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037008",
            "telephone_number": "907-226-3400",
            "fax_number": "907-226-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 A ST STE 405",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995034040",
            "telephone_number": "907-444-8876",
            "fax_number": "907-782-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-18",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "HALPIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-226-3400"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; 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.