PERFORMANCE HOME MEDICAL – Oxygen Equipment & Supplies (DME), NPI 1891934378
Oxygen Equipment & Supplies (DME)
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for PERFORMANCE HOME MEDICAL
703 LILLY RD NE STE 102
OLYMPIA, WA 985065191
Phone: (360) 456-4052
Fax: (360) 455-7471
Type: Location
19625, 62nd Avenue South, Kent, King County, Washington, 98032, United States
SUITE A101
KENT, WA 980321103
Phone: (360) 456-4052
Fax: (360) 455-7471
Type: Mailing
703, Lilly Road Northeast, Olympia, Thurston County, Washington, 98506, United States
SUITE 101
OLYMPIA, WA 985065191
Phone: (360) 456-4052
Fax: (360) 455-7471
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (193 days ago).
Enrollment records
1
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930069069 | O | Medical Supply Company | WA | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98506)
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