EAST SOUTHERN MEDICAL GROUP, LLC
NPI 1477011237
Physical Medicine & Rehabilitation in Mesa, AZ
About East Southern Medical Group, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST SOUTHERN MEDICAL GROUP, LLC (NPI 1477011237) is a healthcare organization registered as a physical medicine & rehabilitation in Mesa, Arizona and active in the NPI registry since March 2019. The organization lists Derek P Pruni, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
East Southern Medical Group, Llc 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
2Medicare enrollment records show 2 clinicians reassign Medicare billing to East Southern Medical Group, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 2
Medicare supplier enrollment and the product categories East Southern Medical Group LLC carries, from the Medicare DMEPOS supplier directory.
East Southern Medical Group LLC
DMEPOS supplier · Mesa, AZAccepts Medicare assignment
East Southern Medical Group LLC 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.
Medicare Product Categories
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 East Southern Medical Group, LLC's NPI number?
The NPI number for East Southern Medical Group, LLC is 1477011237. It was assigned to this organization in the NPPES registry on March 11, 2019.
Where is East Southern Medical Group, LLC located?
East Southern Medical Group, LLC is located at 5233 E Southern Ave Ste 103, Mesa, AZ 85206. The listed phone number is (480) 830-2882.
What is East Southern Medical Group, LLC's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.
Is East Southern Medical Group, LLC enrolled in Medicare?
Yes. East Southern Medical Group, LLC is registered in the Medicare PECOS enrollment system.
When is East Southern Medical Group, LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Arizona, Medical Supply Company) 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 East Southern Medical Group, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to East Southern Medical Group, LLC. 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does East Southern Medical Group, LLC accept Medicare assignment for medical equipment?
Yes. As a Medicare medical equipment supplier, East Southern Medical Group LLC 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 East Southern Medical Group, LLC was last updated on May 2, 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.