Salem Pain and Spine Specialists PC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

SALEM PAIN AND SPINE SPECIALISTS PC

Practice address

1100 22ND St SE
Salem, OR 97302-6558

Phone

(503) 967-6771

Fax

(503) 385-8421

NPI assigned

Jul 19, 2011

Last updated

Nov 27, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carlos A Monreal

Title

Business Manager

Phone

(503) 967-6771

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: spss@direct.wvp.nextgenshare.com

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maya Modzelewska, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Salem, OR
  • NPI 1790074490
  Medicare reassignment Care Compare group NPD
• Rebeca M Monreal, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Salem, OR
  • NPI 1144428079
  Medicare reassignment Care Compare group
• Eugene Oleg Vakhovsky, PA-C

  • Physician Assistant
  • Stayton, OR
  • NPI 1518637016
  Medicare reassignment Care Compare group
• Kristen Bessler Brusky, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Lebanon, OR
  • NPI 1538401724

  Neuromusculoskeletal Medicine & Omm

  Medicare reassignment NPD
• Jordan S Garman, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mather, CA
  • NPI 1710240791

  OR

  Medicare reassignment NPD
• Robert J Wissner, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Akron, OH
  • NPI 1306374210

  OR

  Medicare reassignment NPD
• Angela T Young, PA-C

  • Physician Assistant
  • Salem, OR
  • NPI 1578546743
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1124316567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 22ND ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026558",
            "telephone_number": "503-967-6771",
            "fax_number": "503-385-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 22ND ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973026558",
            "telephone_number": "503-967-6771",
            "fax_number": "503-385-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM PAIN AND SPINE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "MONREAL",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "503-967-6771"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spss@direct.wvp.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Salem Pain and Spine Specialists PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1100 22nd St SE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973026558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Salem Nurse Midwives
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• Salem Pastoral Counseling Center
• Salem Pediatric Clinic
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• Salem Psychiatric Associates PC (Valley Mental Health)
• Salem Psychiatric Associates, P.C. (Valley Mental Health)

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Salem, OR
• Providers in Salem, OR by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.