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ACTIVE LIFE, LLC
NPI 1073162244
Prosthetic/Orthotic Supplier in Lakewood, CA

Active since September 10, 2019
3300 E SOUTH ST STE 305, LAKEWOOD, CA 90805(562) 304-9866(562) 304-9845 Get Directions Write a Review

NPPES record last updated: January 23, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 23, 2023, Jan 14, 2021, Sep 10, 2019 (3 updates tracked since 2019).

About Active Life, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ACTIVE LIFE, LLC (NPI 1073162244) is a healthcare organization registered as a prosthetic/orthotic supplier in Lakewood, California and active in the NPI registry since September 2019. The organization lists Pallavi Chintapalli Nemani, Compliance Officer, as its authorized official.

NPPES Registry Identity

NPI1073162244
Entity TypeOrganization
Primary Taxonomy335E00000X
Legal Business NameACTIVE LIFE, LLC
Location Address3300 E SOUTH ST STE 305Lakewood, CA 90805-4595
Mailing Address1577 E Chevy Chase Dr Ste 210Glendale, CA 91206-4741 · (818) 495-4610 · Fax (818) 484-2812
Phone(562) 304-9866
Fax(562) 304-9845
Organization SubpartNo
Authorized OfficialPallavi Chintapalli NemaniCompliance Officer · (512) 552-6311
Enumeration DateSeptember 10, 2019
Last NPPES UpdateJanuary 23, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2023
✔ NPI 1073162244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
Definition
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.
3300 E SOUTH ST STE 305, Lakewood, CA 90805
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Other Identifiers 1

MedicaidXC0009601CA

Medical Equipment Supplier Medicare DMEPOS 9

Medicare supplier enrollment and the product categories Active Life LLC carries, from the Medicare DMEPOS supplier directory.

Active Life LLC

DMEPOS supplier · Lakewood, CA
⋮

Does not accept Medicare assignment

Active Life LLC has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20588549
Medicare Participant SinceMay 11, 2004
Supplier Location3300 E South St Ste 305Lakewood, CA 90805
Phone(562) 470-7070
Provider TypeCertified Orth/Pros/Pedorthist

Medicare Product Categories

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
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROHEALTH PARTNERS A MEDICAL GROUP
Family Medicine
3300 E SOUTH ST STE 305
LAKEWOOD, CA 90805
Los Angeles County (562) 421-7292
MISS JEAN RHADENIE HERNANDEZ MONTES FNP-C
Nurse Practitioner (Family)
3300 E SOUTH ST STE 305
LAKEWOOD, CA 90805
Los Angeles County No phone listed

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Active Life, LLC's NPI number?

The NPI number for Active Life, LLC is 1073162244. It was assigned to this organization in the NPPES registry on September 10, 2019.

Where is Active Life, LLC located?

Active Life, LLC is located at 3300 E South St Ste 305, Lakewood, CA 90805. The listed phone number is (562) 304-9866.

What is Active Life, LLC's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Does Active Life, LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Active Life LLC does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

When was this NPI record last updated?

The NPPES record for Active Life, LLC was last updated on January 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.