BRILLIANT MEDICAL BOUTIQUE, LLC
NPI 1770751950
Durable Medical Equipment & Medical Supplies in Fort Worth, TX
NPI Status: Active since February 11, 2008
Contact Information
6800 HARRIS PKWY STE 300
FORT WORTH, TX
ZIP 76132
Phone: (682) 312-9300
Fax: (682) 312-9133
- Organization
- Durable Medical Equipment & Medical Supp...
- 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 Fort Worth, Texas operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1770751950 assigned on February 2008. 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)
- NPI
- 1770751950
- Provider Name
- BRILLIANT MEDICAL BOUTIQUE, LLC
- Entity Type
- Organization
- Location Address
- 6800 HARRIS PKWY STE 300 FORT WORTH, TX 76132
- Location Phone
- (682) 312-9300
- Location Fax
- (682) 312-9133
- Mailing Address
- 6800 HARRIS PKWY STE 300 FORT WORTH, TX 76132
- Mailing Phone
- (682) 312-9300
- Mailing Fax
- (682) 312-9133
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-11-2008
- Last Update Date
- 09-08-2022
- Code Navigator
Brilliant Medical Boutique, Llc is a medicare supplier with PTAN 20574611 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 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 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 | CFM01117 (TN) |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20574611
- 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
- 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
- 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 1770751950, 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 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 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770751950, enumerated as an "organization" on February 11, 2008.
The provider is located at 6800 HARRIS PKWY STE 300 FORT WORTH, TX 76132 and the phone number is (682) 312-9300.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
