Organization Active NPI

Advanced DME LLC

  • Durable Medical Equipment & Medical Supplies
  • San Jose, CA
National Provider Identifier
1962083733
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ADVANCED DME LLC
Practice address
3315 Almaden Expy Ste 20
San Jose, CA 95118-1557
Phone
(408) 264-6644
NPI assigned
Apr 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Dr. Brian Coyle, DCNPI 1417029612
Title
Owner
Phone
(408) 396-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3315 Almaden Expy Ste 20
San Jose, CA 95118-1557

Mailing address

6707 38TH Ave N
Saint Petersburg, FL 33710-1536
Phone (727) 800-9958

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231027000668 CA DME Supplier - Physician - Unknown Physician Specialty 6608222609 Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

3315 Almaden Expy
Ste 20
San Jose, CA 95118
Phone (408) 264-6644

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1962083733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 38TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337101536",
            "telephone_number": "727-800-9958",
            "fax_number": "855-552-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 ALMADEN EXPY STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951181557",
            "telephone_number": "408-264-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-396-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.