ACTIVE LIFE PHYSICAL MEDICINE AND PAIN CENTER, PLLC
NPI 1811130016
Physical Medicine & Rehabilitation - Pain Medicine in Surprise, AZ
About Active Life Physical Medicine And Pain Center, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ACTIVE LIFE PHYSICAL MEDICINE AND PAIN CENTER, PLLC (NPI 1811130016) is a healthcare organization registered as a pain medicine in Surprise, Arizona and active in the NPI registry since April 2009. The organization holds 2 active CLIA laboratory certificates and lists Wendi Lundquist, Owner/physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Active Life Physical Medicine And Pain Center, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 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 Active Life Physical Medicine And Pain Center, PLLC, which bills Medicare for the services they deliver. Of these, 1 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.
CLIA Laboratory Certificates CMS CLIA 2
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 03D2128471
Active Life Physical Medicine & Pain Center · Surprise, AZCertificate of Waiver 03D1104696
Active Life Physical Medicine & Pain Center · Litchfield Park, AZFrequently 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 Active Life Physical Medicine And Pain Center, PLLC's NPI number?
The NPI number for Active Life Physical Medicine And Pain Center, PLLC is 1811130016. It was assigned to this organization in the NPPES registry on April 17, 2009.
Where is Active Life Physical Medicine And Pain Center, PLLC located?
Active Life Physical Medicine And Pain Center, PLLC is located at 15547 N Reems Rd Bldg A, Surprise, AZ 85374. The listed phone number is (623) 535-9777.
What is Active Life Physical Medicine And Pain Center, PLLC's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.
Is Active Life Physical Medicine And Pain Center, PLLC enrolled in Medicare?
Yes. Active Life Physical Medicine And Pain Center, PLLC is registered in the Medicare PECOS enrollment system.
When is Active Life Physical Medicine And Pain Center, PLLC'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 March 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 Active Life Physical Medicine And Pain Center, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Pain Management, reassign their Medicare billing to Active Life Physical Medicine And Pain Center, 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Active Life Physical Medicine And Pain Center, PLLC hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Active Life Physical Medicine And Pain Center, PLLC accept?
Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Active Life Physical Medicine And Pain Center, PLLC 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 Active Life Physical Medicine And Pain Center, PLLC was last updated on May 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.
# Active Life Physical Medicine And Pain Center, Pllc · NPI 1811130016
Pain Medicine organization in Surprise, Arizona. Organization record, active in the CMS NPPES registry since April 17, 2009.
## Identity
- **NPI:** 1811130016 (Entity type: Organization)
- **Enumerated:** April 17, 2009
- **Primary specialty:** Physical Medicine & Rehabilitation - Pain Medicine · taxonomy 2081P2900X
- **Organization subpart:** No
- **Authorized official:** Wendi Lundquist, OWNER/PHYSICIAN
## Practice location
- **Address:** 15547 N REEMS RD BLDG A, Surprise, AZ 85374-9583
- **Phone:** (623) 535-9777 · **Fax:** (623) 535-9778
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Arizona, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Pain Management) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 29, 2023
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1811130016) · Data from the CMS NPPES public registry.