1. Home
  2. Directory
  3. Oregon
  4. Salem
  5. Physical Medicine Rehabilitation
  6. NPI Profile

SALEM PAIN AND SPINE SPECIALISTS PC
NPI 1124316567
Physical Medicine & Rehabilitation - Pain Medicine in Salem, OR

Active since July 19, 2011CLIA 38D2033022 · Waiver
1100 22ND ST SE, SALEM, OR 97302(503) 967-6771(503) 385-8421 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 20, 2020, Apr 2, 2019 (2 updates tracked since 2019).

About Salem Pain And Spine Specialists Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SALEM PAIN AND SPINE SPECIALISTS PC (NPI 1124316567) is a healthcare organization registered as a pain medicine in Salem, Oregon and active in the NPI registry since July 2011. The organization holds a CLIA Waiver certificate valid through November 20, 2027 and lists Carlos A Monreal, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1124316567
Entity TypeOrganization
Primary Taxonomy2081P2900X
Legal Business NameSALEM PAIN AND SPINE SPECIALISTS PC
Location Address1100 22ND ST SESalem, OR 97302-6558
Mailing Address1100 22nd St SeSalem, OR 97302-6558 · (503) 967-6771 · Fax (503) 385-8421
Phone(503) 967-6771
Fax(503) 385-8421
Organization SubpartNo
Authorized OfficialCarlos A MonrealBusiness Manager · (503) 967-6771
Enumeration DateJuly 19, 2011
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
NPPES CertifiedOctober 20, 2020
✔ NPI 1124316567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
Definition
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Also ListedNeuromusculoskeletal Medicine & OMMTaxonomy 204D00000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
1100 22ND ST SE, Salem, OR 97302
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Salem Pain And Spine Specialists Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateOregonEnrollment IDO20120113000808Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Salem Pain And Spine Specialists PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Maya Modzelewska, M.D.
Physical Medicine and Rehabilitation
NPI 1790074490
1100 22ND ST SE
Salem, OR 97302
(585) 275-3274
✔ PECOS✔ Accepts MedicareSame address
Rebeca Monreal, DO
Physical Medicine and Rehabilitation
NPI 1144428079
1100 22ND ST SE
Salem, OR 97302
(503) 967-6771
✔ PECOS✔ Accepts MedicareSame address
Kristen Brusky, D.O.
Physical Medicine and Rehabilitation
NPI 1538401724
675 N 5TH ST
Lebanon, OR 97355
(541) 451-6282
✔ PECOS✔ Accepts Medicare26 mi
Jordan Garman, D.O.
Physical Medicine and Rehabilitation
NPI 1710240791
10535 HOSPITAL WAY
Mather, CA 95655
(916) 595-2779
✔ PECOS✔ Accepts Medicare447 mi
Robert Wissner, DO
Pain Management
NPI 1306374210
2603 W MARKET ST STE 200
Akron, OH 44313
(800) 941-6672
✔ PECOS✔ Accepts Medicare2,091 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D2033022

Salem Pain And Spine Specialists · Salem, OR
Active · expires Nov 20, 2027
CLIA Number38D2033022
Laboratory TypePhysician Office
Certificate Effective DateNovember 21, 2025
Certificate Expiration DateNovember 20, 2027
Laboratory DirectorRebeca M Monreal
Laboratory Phone(503) 967-6771
Laboratory LocationSalem Pain And Spine Specialists1100 22nd St SE, Salem, OR 97302
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Salem Pain And Spine Specialists PC's NPI number?

The NPI number for Salem Pain And Spine Specialists PC is 1124316567. It was assigned to this organization in the NPPES registry on July 19, 2011.

Where is Salem Pain And Spine Specialists PC located?

Salem Pain And Spine Specialists PC is located at 1100 22nd St SE, Salem, OR 97302. The listed phone number is (503) 967-6771.

What is Salem Pain And Spine Specialists PC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Is Salem Pain And Spine Specialists PC enrolled in Medicare?

Yes. Salem Pain And Spine Specialists PC is registered in the Medicare PECOS enrollment system.

When is Salem Pain And Spine Specialists PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oregon, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Salem Pain And Spine Specialists PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Salem Pain And Spine Specialists PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Physical Medicine and Rehabilitation (4) and Pain Management (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Salem Pain And Spine Specialists PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2033022) is associated with this NPI, valid through November 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Salem Pain And Spine Specialists PC accept?

Health plans from Moda Health Plan, Inc. list Salem Pain And Spine Specialists PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Salem Pain And Spine Specialists PC was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.