Individual provider Active NPI

Angela Gonsalves, DPT

  • Physical Therapist
  • Peoria, AZ
National Provider Identifier
1376135822
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
26900 N Lake Pleasant Pkwy Ste 120
Peoria, AZ 85383-1590
Phone
(623) 400-9100
Fax
(623) 400-9101
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X AZ Primary

Addresses

Primary practice location

26900 N Lake Pleasant Pkwy Ste 120
Peoria, AZ 85383-1590

Mailing address

14287 N 87TH St Ste 220
Scottsdale, AZ 85260-3698
Phone (480) 551-4948

Other practice location 1

5281 N 99th Ave Ste 200
Glendale, AZ 85305-3199
Phone (623) 889-0411

Other practice location 2

4212 N 16th St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210319000951 AZ Practitioner - Physical Therapist in Private Practice 9830506716 Reassigns benefits to 2 organizations
I20240503000553 TX Practitioner - Physical Therapist in Private Practice 9830506716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Sports Medicine LLCGroup PAC ID 6800228479, 40 clinicians

Practice addresses (Care Compare)

26900 N Lake Pleasant Pkwy
Suite 120
Peoria, AZ 85383-1394
Phone (623) 400-9100

406 N Litchfield Rd
Suite 204
Goodyear, AZ 85338-1200
Phone (480) 306-6627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jan 14, 2024 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jan 14, 2024 Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Feb 17, 2021 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Feb 17, 2021 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Past Accepting new patients

Locations

5281 N 99th Ave
Ste 200
Glendale, AZ 85305
Phone (623) 889-0411

26900 N Lake Pleasant Pkwy
Ste 120
Peoria, AZ 85383
Phone (623) 400-9100

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

14287 N 87th St
Ste 220
Scottsdale, AZ 85260

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1376135822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14287 N 87TH ST STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603698",
            "telephone_number": "480-551-4948",
            "fax_number": "480-860-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26900 N LAKE PLEASANT PKWY STE 120",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853831590",
            "telephone_number": "623-400-9100",
            "fax_number": "623-400-9101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5281 N 99th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853053199",
            "country_code": "US",
            "telephone_number": "623-889-0411",
            "fax_number": "623-889-0410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4212 N 16th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850165319",
            "country_code": "US",
            "telephone_number": "602-263-1200",
            "fax_number": "602-263-1619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONSALVES",
        "first_name": "ANGELA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.