Brilliant Medical Boutique, LLC
NPI 1770751950 · Durable Medical Equipment & Medical Supplies · Fort Worth, TX
Enrolled with Medicare as Dme Supplier - Medical Supply Company · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Brilliant Medical Boutique, LLC is a Durable Medical Equipment & Medical Supplies organization in Fort Worth, TX (NPI 1770751950).
Provider details
- NPI number
- 1770751950
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Jamie Mittendorf, Owner(817) 594-5868
- License
- CFM01117 (TN)
Specialties & taxonomies
Suppliers
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-02-11
- Last updated
- 2022-09-08
- Certified
- 2022-09-08
Frequently asked questions
- What is Brilliant Medical Boutique, LLC's NPI number?
- Brilliant Medical Boutique, LLC's National Provider Identifier (NPI) is 1770751950, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Brilliant Medical Boutique, LLC?
- Brilliant Medical Boutique, LLC is classified in the NPPES registry as Durable Medical Equipment & Medical Supplies (Suppliers).
- Where is Brilliant Medical Boutique, LLC located?
- Brilliant Medical Boutique, LLC's practice location on file with NPPES is 6800 Harris Pkwy Ste 300, Fort Worth, TX 76132-4262.
- What is Brilliant Medical Boutique, LLC's phone number?
- The practice phone number listed in the NPPES registry for Brilliant Medical Boutique, LLC is (682) 312-9300.
- Does Brilliant Medical Boutique, LLC accept Medicare?
- Brilliant Medical Boutique, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Brilliant Medical Boutique, LLC?
- The authorized official listed on Brilliant Medical Boutique, LLC's NPPES record is Jamie Mittendorf, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Brilliant Medical Boutique, LLC's NPI active?
- Yes — Brilliant Medical Boutique, LLC's NPI (1770751950) is active in the NPPES registry as of the last update on 2022-09-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.