GONSTEAD PHYSICAL MEDICINE PC
NPI 1316163751
Chiropractor in Phoenix, AZ
About Gonstead Physical Medicine Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GONSTEAD PHYSICAL MEDICINE PC (NPI 1316163751), doing business as Gonstead Spine Institute Pc, is a healthcare organization registered as a chiropractor in Phoenix, Arizona and active in the NPI registry since April 2007. The organization lists Jose Lara, Chiropractor, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
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)
Gonstead Physical Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
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.
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Gonstead Physical Medicine PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (8)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Gonstead Physical Medicine PC's NPI number?
The NPI number for Gonstead Physical Medicine PC is 1316163751. It was assigned to this organization in the NPPES registry on April 17, 2007. The provider was formerly known as Gonstead Spine Institute PC.
Where is Gonstead Physical Medicine PC located?
Gonstead Physical Medicine PC is located at 2735 W Union Hills Dr Suite 102, Phoenix, AZ 85027. The listed phone number is (602) 973-1630.
What is Gonstead Physical Medicine PC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Gonstead Physical Medicine PC enrolled in Medicare?
Yes. Gonstead Physical Medicine PC is registered in the Medicare PECOS enrollment system.
When is Gonstead Physical Medicine 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 (Arizona, Clinic/Group Practice) is due for revalidation by January 31, 2027. 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 Gonstead Physical Medicine PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians, all in Chiropractic, reassign their Medicare billing to Gonstead Physical Medicine 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Gonstead Physical Medicine PC was last updated on June 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Gonstead Physical Medicine Pc · NPI 1316163751
Chiropractor organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since April 17, 2007.
## Identity
- **NPI:** 1316163751 (Entity type: Organization)
- **Enumerated:** April 17, 2007
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Jose Lara, CHIROPRACTOR
## Practice location
- **Address:** 2735 W UNION HILLS DR, SUITE 102, Phoenix, AZ 85027-5033
- **Phone:** (602) 973-1630 · **Fax:** (602) 973-1667
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Arizona, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 8 clinicians (Chiropractic) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 17, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1316163751) · Data from the CMS NPPES public registry.