MEDISOURCE HOME MEDICAL
NPI 1770501736
Durable Medical Equipment & Medical Supplies - Customized Equipment in Kennesaw, GA

NPI Status: Active since July 18, 2006

Contact Information

975 COBB PLACE BLVD NW STE 113
KENNESAW, GA
ZIP 30144
Phone: (770) 528-9559
Fax: (770) 528-9309

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  • Organization
  • Durable Medical Equipment & Medical Supp...
  • Customized Equipment
  • Accepts Insurance
  • Medicare Supplier
  • Does Not Accept Medicare Approved Payment

About MEDISOURCE HOME MEDICAL

This page provides the complete NPI Profile along with additional information for Medisource Home Medical, a provider established in Kennesaw, Georgia operating as a Durable Medical Equipment & Medical Supplies, focusing in customized equipment . The healthcare provider is registered in the NPI registry with number 1770501736 assigned on July 2006. The practitioner's primary taxonomy code is 332BC3200X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mr. Sergio Silva Sr. (Owner)

NPI
1770501736
Provider Name
MEDISOURCE HOME MEDICAL
Entity Type
Organization
Location Address
975 COBB PLACE BLVD NW STE 113 KENNESAW, GA 30144
Location Phone
(770) 528-9559
Location Fax
(770) 528-9309
Mailing Address
975 COBB PLACE BLVD NW STE 113 KENNESAW, GA 30144
Mailing Phone
(770) 528-9559
Mailing Fax
(770) 528-9309
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-18-2006
Last Update Date
10-13-2020
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Medisource Home Medical is a medicare supplier with PTAN 20523353 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 Blood Glucose Monitors/Supplies (Non-Mail Order) or Heat & Cold Applications or Hospital Beds (Electric) or Hospital Beds (Manual) or Support Surfaces: Pressure Reducing Beds/Mats/Pads or Traction Equipment or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Patient Lifts 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 Orthoses: Off-The-Shelf or Penile Pumps or Ostomy Supplies or Urological Supplies or Continuous Positive Airway Pressure (CPAP) Devices or Nebulizer Equipment and/or Supplies or Oxygen Equipment and/or Supplies or Respiratory Suction Pumps or Surgical Dressings or Diabetic Shoes and Inserts.

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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 Customized Equipment

Taxonomy Code
332BC3200X
Type
Suppliers

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)
1332B00000XSuppliers

Durable Medical Equipment & Medical Supplies

 
2332BX2000XSuppliers

Durable Medical Equipment & Medical Supplies
Oxygen Equipment & Supplies

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • MENDING Direct Primary Care Bronze 4950 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Gold $0 Ded ($0 DPC $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Silver 2300 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
  • MENDING Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
  • MENDING Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - 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.

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. SERGIO SILVA SR.

Authorized Official Title
OWNER
Authorized Official Phone
(770) 528-9559

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
341310291AMEDICAID (05)GA 
52164995OTHER (01)GABCBS
1023735OTHER (01)GAUHC

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20523353
Accepts Medicare Assignment
NO
Specialities List
Medical Supply Company Other.
Provider Type List
OXYGEN & EQUIPMENT.
Competitive Bidding
NO

Supplies List

  • Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
  • Hospital Beds (Electric) - Total electric hospital beds, Semi-electric hospital beds
  • Hospital Beds (Manual) - Fixed height hospital beds, Variable height hospital beds
  • Support Surfaces: Pressure Reducing Beds/Mats/Pads - Group 1 – Alternating pressure pad, Air/Water/Dry pressure pad or pressure mattress. Group 2 - Pressure reducing powered air mattresses, Powered air flotation bed, non-powered pressure reducing mattress Group 3 – Air fluidized bed
  • 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
  • Patient Lifts - Ceiling lifts, Slings
  • 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
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Penile Pumps -
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Continuous Positive Airway Pressure (CPAP) Devices - CPAP machines, Compressor systems, Humidifiers, Masks
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Oxygen Equipment and/or Supplies - Portable oxygen systems, Oxygen concentrators, Oxygen contents
  • Respiratory Suction Pumps - Portable suction pumps, Stationary suction pumps, Canisters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
  • Diabetic Shoes and Inserts - Shoes, Socks, Insoles

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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 1770501736, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

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.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
7
Unchanged
Pos 9
3
Doubled → 6
Check
6
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 5 → 10 → 1 1 → 2 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 1 + 0 + 0 + 2 + 7 + 6 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1770501736.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770501736, enumerated as an "organization" on July 18, 2006.

The provider is located at 975 COBB PLACE BLVD NW STE 113 KENNESAW, GA 30144 and the phone number is (770) 528-9559.

Durable Medical Equipment & Medical Supplies with taxonomy code 332BC3200X and a focus in Customized Equipment.

The provider might be accepting Accepts: Mending Health, Medicare, Medicaid and Blue Cross. Please consult your insurance carrier or call the provider to verify.