PRESTIGE MED INC
NPI 1447510789
Internal Medicine in San Ramon, CA

Active since May 21, 2012
11030 BOLLINGER CANYON RD, STE 240, SAN RAMON, CA 94582(925) 718-6622(201) 690-8632 Get Directions Write a Review

NPPES record last updated: November 12, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Prestige Med Inc NPPES

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

PRESTIGE MED INC (NPI 1447510789) is a healthcare organization registered as an internal medicine in San Ramon, California and active in the NPI registry since May 2012. The organization lists Joseph Y Mardanzai, Owner, as its authorized official.

NPPES Registry Identity

NPI1447510789
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePRESTIGE MED INC
Location Address11030 BOLLINGER CANYON RD, STE 240San Ramon, CA 94582-4874
Mailing AddressPo Box 3888San Ramon, CA 94583-8888 · (925) 718-6622 · Fax (201) 690-8632
Fax(201) 690-8632
Organization SubpartNo
Authorized OfficialJoseph Y MardanzaiOwner · (925) 718-6622
Enumeration DateMay 21, 2012
Last NPPES UpdateNovember 12, 2015
✔ NPI 1447510789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A80856
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License A80856 (CA)
11030 BOLLINGER CANYON RD, San Ramon, CA 94582

Other Identifiers 1

OtherGF086ACA · Medicare Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prestige Med Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20120702000130Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Prestige Med Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Internal Medicine
NPI 1043220031
11030 BOLLINGER CANYON RD STE 240
San Ramon, CA 94582
(925) 736-1000
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Prestige Med Inc's NPI number?

The NPI number for Prestige Med Inc is 1447510789. It was assigned to this organization in the NPPES registry on May 21, 2012.

Where is Prestige Med Inc located?

Prestige Med Inc is located at 11030 Bollinger Canyon Rd Ste 240, San Ramon, CA 94582. The listed phone number is (925) 718-6622.

What is Prestige Med Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prestige Med Inc enrolled in Medicare?

Yes. Prestige Med Inc is registered in the Medicare PECOS enrollment system.

When is Prestige Med Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Prestige Med Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Prestige Med Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Prestige Med Inc was last updated on November 12, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.