ACTIVE LIFE, LLC
NPI 1073162244
Prosthetic/Orthotic Supplier in Lakewood, CA
NPI Status: Active since September 10, 2019
Contact Information
3300 E SOUTH ST STE 305
LAKEWOOD, CA
ZIP 90805
Phone: (562) 304-9866
Fax: (562) 304-9845
- Organization
- Prosthetic/Orthotic Supplier
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
About ACTIVE LIFE, LLC
This page provides the complete NPI Profile along with additional information for Active Life, Llc, a provider established in Lakewood, California operating as a Prosthetic/orthotic Supplier. The healthcare provider is registered in the NPI registry with number 1073162244 assigned on September 2019. The practitioner's primary taxonomy code is 335E00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Pallavi Chintapalli Nemani (Compliance Officer)
- NPI
- 1073162244
- Provider Name
- ACTIVE LIFE, LLC
- Entity Type
- Organization
- Location Address
- 3300 E SOUTH ST STE 305 LAKEWOOD, CA 90805
- Location Phone
- (562) 304-9866
- Location Fax
- (562) 304-9845
- Mailing Address
- 1577 E CHEVY CHASE DR STE 210 GLENDALE, CA 91206
- Mailing Phone
- (818) 495-4610
- Mailing Fax
- (562) 304-9845
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-10-2019
- Last Update Date
- 01-23-2023
- Code Navigator
Active Life, Llc is a medicare supplier with PTAN 20588549 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Orthoses: Custom Fabricated or Orthoses: Prefabricated (Non-Custom Fabricated) or Orthoses: Off-The-Shelf or Breast Prostheses and/or Accessories or Limb Prostheses or Surgical Dressings or Diabetic Shoes and Inserts or Diabetic Shoes/Inserts - Custom or Lymphedema Compression Treatment Items.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Prosthetic/Orthotic Supplier
- Taxonomy Code
- 335E00000X
- Type
- Suppliers
- Taxonomy Description
- An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| XC0009601 | MEDICAID (05) | CA |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20588549
- Accepts Medicare Assignment
- NO
- Provider Type List
- CERTIFIED ORTH/PROS/PEDORTHIST.
- Competitive Bidding
- NO
Supplies List
- Orthoses: Custom Fabricated - Custom met pads, Custom heel pads, Custom heel spur pads
- Orthoses: Prefabricated (Non-Custom Fabricated) - Met pads, Heel pads, Heel spur pads
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Breast Prostheses and/or Accessories - Prosthetic bra, Surgical bra
- Limb Prostheses - Prosthetic arms, Prosthetic feet, Prosthetic knees
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Diabetic Shoes and Inserts - Shoes, Socks, Insoles
- Diabetic Shoes/Inserts - Custom - Custom fabricated shoes, socks, & insoles
- Lymphedema Compression Treatment Items -
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 7 | 3 | 1 | 6 | 2 | 2 | 4 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 14 | 3 | 2 | 6 | 4 | 2 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 4 + 3 + 2 + 6 + 4 + 2 + 8 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1073162244 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
MISS JEAN RHADENIE HERNANDEZ MONTES FNP-C
Nurse Practitioner
(Family)
3300 E SOUTH ST STE 305
LAKEWOOD, CA
ZIP 90805
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073162244, enumerated as an "organization" on September 10, 2019.
The provider is located at 3300 E SOUTH ST STE 305 LAKEWOOD, CA 90805 and the phone number is (562) 304-9866.
Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
