BRILLIANT MEDICAL BOUTIQUE LLC
NPI 1497793830
Durable Medical Equipment & Medical Supplies in Weatherford, TX
NPI Status: Active since June 04, 2006
Contact Information
925 SANTA FE DR
SUITE 100
WEATHERFORD, TX
ZIP 76086
Phone: (817) 594-5868
Fax: (817) 594-5833
- Organization
- Durable Medical Equipment & Medical Supp...
- Accepts Insurance
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
About BRILLIANT MEDICAL BOUTIQUE LLC
This page provides the complete NPI Profile along with additional information for Brilliant Medical Boutique Llc, a provider established in Weatherford, Texas operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1497793830 assigned on June 2006. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Jamie B. Mittendorf (Owner And Operator)
- NPI
- 1497793830
- Provider Name
- BRILLIANT MEDICAL BOUTIQUE LLC
- Entity Type
- Organization
- Location Address
- 925 SANTA FE DR SUITE 100 WEATHERFORD, TX 76086
- Location Phone
- (817) 594-5868
- Location Fax
- (817) 594-5833
- Mailing Address
- 925 SANTA FE DR SUITE 100 WEATHERFORD, TX 76086
- Mailing Phone
- (817) 594-5868
- Mailing Fax
- (817) 594-5833
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-04-2006
- Last Update Date
- 09-08-2022
- Code Navigator
Brilliant Medical Boutique Llc is a medicare supplier with PTAN 20574659 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: Commodes, Urinals, Bedpans or Hospital Beds (Electric) or Pneumatic Compression Devices and/or Supplies or Traction Equipment or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Power Operated Vehicles (Scooters) or Seat Lift Mechanisms or Walkers or Wheelchairs (Standard Manual) or Wheelchairs (Standard Manual Related Accessories) or Wheelchairs (Standard Power) or Wheelchairs (Standard Power Related Accessories) or Wheelchair Seating/Cushions or Breast Prostheses and/or Accessories or Ostomy Supplies or Urological Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings 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
Durable Medical Equipment & Medical Supplies
- Taxonomy Code
- 332B00000X
- Type
- Suppliers
- Taxonomy Description
- A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 335E00000X | Suppliers | Prosthetic/Orthotic Supplier |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard+ (Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Standard - HMO
- UHC Silver Value ($0 Virtual Urgent Care) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
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 |
|---|---|---|---|
| 178601402 | MEDICAID (05) | TX |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20574659
- Accepts Medicare Assignment
- NO
- Specialities List
- Medical Supply Company Other, MSC With Prosthetic Personnel.
- Competitive Bidding
- NO
Supplies List
- Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
- Hospital Beds (Electric) - Total electric hospital beds, Semi-electric hospital beds
- Pneumatic Compression Devices and/or Supplies - Pnuematic compressor, Arm pneumatic appliance, Leg pneumatic appliance
- Traction Equipment - Traction tables, Traction machines, Inversion tables
- (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Power Operated Vehicles (Scooters) - Scooters
- Seat Lift Mechanisms - Lift chair
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Wheelchairs (Standard Manual) - Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Manual Related Accessories) - Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Power) - Standard power wheelchairs, Heavy duty standard power wheelchairs
- Wheelchairs (Standard Power Related Accessories) - Accessories for standard power wheelchairs, heavy duty standard power wheelchairs
- Wheelchair Seating/Cushions - Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
- Breast Prostheses and/or Accessories - Prosthetic bra, Surgical bra
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Urological Supplies - Catheters, Urinary collection devices
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
- Lymphedema Compression Treatment Items -
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1497793830, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 80. The final step is to find the difference between that total and the next multiple of ten (80 - 80 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 80 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
WEATHERFORD, TX 76086
WEATHERFORD, TX 76086
WEATHERFORD, TX 76086
WEATHERFORD, TX 76086
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497793830, enumerated as an "organization" on June 04, 2006.
The provider is located at 925 SANTA FE DR SUITE 100 WEATHERFORD, TX 76086 and the phone number is (817) 594-5868.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
The provider might be accepting Accepts: UnitedHealthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
