RESTORE VASCULAR PLLC
NPI 1396452611
Phlebology in Queen Creek, AZ

Active since November 07, 2022
18510 E SAN TAN BLVD STE 115, QUEEN CREEK, AZ 85142(480) 442-3990 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 29, 2023, Nov 27, 2022, Nov 7, 2022 (3 updates tracked since 2022).

About Restore Vascular Pllc NPPES

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

RESTORE VASCULAR PLLC (NPI 1396452611) is a healthcare organization registered as a phlebology in Queen Creek, Arizona and active in the NPI registry since November 2022. The organization maintains 2 additional practice locations and lists Nathan Ian Weller, Owner, as its authorized official.

NPPES Registry Identity

NPI1396452611
Entity TypeOrganization
Primary Taxonomy202K00000X
Legal Business NameRESTORE VASCULAR PLLC
Location Address18510 E SAN TAN BLVD STE 115Queen Creek, AZ 85142-2206
Mailing Address18510 E San Tan Blvd Ste 115Queen Creek, AZ 85142-2206 · (480) 442-3990
Organization SubpartNo
Authorized OfficialNathan Ian WellerOwner · (480) 874-6808
Enumeration DateNovember 7, 2022
Last NPPES UpdateAugust 29, 20233 updates tracked since enumeration
NPPES CertifiedAugust 29, 2023
✔ NPI 1396452611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPhlebologyAllopathic & Osteopathic Physicians
Taxonomy Code202K00000X
Definition
Phlebology is the medical discipline that involves the diagnosis and treatment of venous disorders, including spider veins, varicose veins, chronic venous insufficiency, venous leg ulcers, congenital venous abnormalities, venous thromboembolism and other disorders of venous origin. A phlebologist has attained a minimum of 50 hours of CME units in phlebology-related courses, and is knowledgeable of and trained in a variety of diagnostic techniques including physical examination, venous imaging techniques such as duplex ultrasound, CT and MR, plethysmographic techniques and laboratory evaluation related to venous thromboembolism. The phlebologist is also trained in a variety of therapeutic interventions, which may include compression, sclerotherapy, cutaneous vascular laser, endovenous thermoablation procedures (laser and radiofrequency) endovenous chemical ablation, surgical procedures (e.g., ambulatory phlebectomy, venous ligation), vasoactive medications and the management of venous thromboembolism.
Also ListedChiropractorTaxonomy 111N00000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
18510 E SAN TAN BLVD STE 115, Queen Creek, AZ 85142

Secondary Practice Locations 2

Location 19200 W Union Hills Dr Ste 103Peoria, AZ 85382-8210 · Phone (480) 442-3990
Location 27555 E Osborn Rd Ste 104Scottsdale, AZ 85251-6468 · Phone (480) 442-3990

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Restore Vascular Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Restore Vascular PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Nurse Practitioner
NPI 1053926410
9354 E THATCHER CIR
Mesa, AZ 85212
(480) 427-8381
✔ PECOS8.1 mi
Internal Medicine
NPI 1821278896
2036 E HACKAMORE ST
Mesa, AZ 85213
(602) 418-9300
✔ PECOS17 mi
Nurse Practitioner
NPI 1689364838
7555 E OSBORN RD STE 104
Scottsdale, AZ 85251
(480) 442-3990
✔ PECOS23 mi
Nurse Practitioner
NPI 1508496167
1010 E MCDOWELL RD STE 103
Phoenix, AZ 85006
(800) 991-6117
✔ PECOS✔ Accepts Medicare28 mi
Chiropractic
NPI 1679627491
1129 W PORTLAND ST
Phoenix, AZ 85007
(831) 801-7092
✔ Accepts Medicare29 mi
Nurse Practitioner
NPI 1801580782
20449 N LAKE PLEASANT RD
Peoria, AZ 85382
(623) 322-0099
✔ PECOS✔ Accepts Medicare47 mi
Chiropractic
NPI 1922302090
57378 29 PALMS HWY
Yucca Valley, CA 92284
(760) 365-1933
280 mi

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

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Restore Wellness Center carries, from the Medicare DMEPOS supplier directory.

Restore Wellness Center

DMEPOS supplier · Queen Creek, AZOperated by Restore Vascular PLLC
✔

Accepts Medicare assignment

Restore Wellness Center agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)34359032
Medicare Participant SinceJanuary 1, 2023
Supplier Location18510 E San Tan Blvd Ste 115Queen Creek, AZ 85142
Supplier Specialties
Medical Supply Company Other

Medicare Product Categories

(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies
Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
Orthoses: Prefabricated (Non-Custom Fabricated)
Met pads, Heel pads, Heel spur pads
Orthoses: Off-The-Shelf
Met pads, Heel pads, Heel spur pads
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Restore Vascular PLLC's NPI number?

The NPI number for Restore Vascular PLLC is 1396452611. It was assigned to this organization in the NPPES registry on November 7, 2022.

Where is Restore Vascular PLLC located?

Restore Vascular PLLC is located at 18510 E San Tan Blvd Ste 115, Queen Creek, AZ 85142. The listed phone number is (480) 442-3990.

What is Restore Vascular PLLC's specialty?

The primary specialty registered for this NPI is Phlebology with taxonomy code 202K00000X.

Is Restore Vascular PLLC enrolled in Medicare?

Yes. Restore Vascular PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Restore Vascular PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Restore Vascular PLLC. 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 Nurse Practitioner (4), Chiropractic (2) and Internal Medicine (1). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Restore Vascular PLLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Restore Wellness Center accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Restore Vascular PLLC was last updated on August 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.