HOLLADAY PHYSICAL MEDICINE
NPI 1487928222
Chiropractor - Orthopedic in Holladay, UT
About Holladay Physical Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HOLLADAY PHYSICAL MEDICINE (NPI 1487928222) is a healthcare organization registered as an orthopedic in Holladay, Utah and active in the NPI registry since February 2012. The organization lists Bruce Van Gundersen, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted 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)
Holladay Physical Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 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
Medicare enrollment records show 1 clinician reassigns Medicare billing to Holladay Physical Medicine, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 P I C Incorporated's NPI number?
The NPI number for P I C Incorporated is 1487928222. It was assigned to this organization in the NPPES registry on February 24, 2012. The provider is doing business as Holladay Physical Medicine.
Where is P I C Incorporated located?
P I C Incorporated is located at 4211 Holladay Blvd, Holladay, UT 84124. The listed phone number is (801) 272-8471.
What is P I C Incorporated's specialty?
The primary specialty registered for this NPI is Chiropractor, specializing in Orthopedic, with taxonomy code 111NX0800X.
Is P I C Incorporated enrolled in Medicare?
Yes. P I C Incorporated is registered in the Medicare PECOS enrollment system.
When is P I C Incorporated'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 (Utah, Clinic/Group Practice) is due for revalidation by February 28, 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 P I C Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to P I C Incorporated. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does P I C Incorporated accept?
Health plans from University of Utah Health Plans list P I C Incorporated 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 P I C Incorporated was last updated on February 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Holladay Physical Medicine · NPI 1487928222
Orthopedic organization in Holladay, Utah. Organization record, active in the CMS NPPES registry since February 24, 2012.
## Identity
- **NPI:** 1487928222 (Entity type: Organization)
- **Enumerated:** February 24, 2012
- **Primary specialty:** Chiropractor - Orthopedic · taxonomy 111NX0800X
- **Legal business name:** P I C Incorporated
- **Organization subpart:** No
- **Authorized official:** Bruce Gundersen, PRESIDENT
## Practice location
- **Address:** 4211 HOLLADAY BLVD, Holladay, UT 84124-2607
- **Phone:** (801) 272-8471
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Utah, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 24, 2012
- **Other identifiers:** Medicare UPIN U000005652 (UT)
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Source: [NPI Profile](https://npiprofile.com/npi/1487928222) · Data from the CMS NPPES public registry.