Individual provider Active NPI

Wendi Joy Lundquist, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Surprise, AZ
National Provider Identifier
1801847546
Registry record updated May 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
005097 Issued in AZ
Practice address
15547 N Reems Rd BLDG a
Surprise, AZ 85374-9583
Phone
(623) 535-9777
Fax
(623) 236-3179
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 4116 WV
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 005097 AZ Primary

Addresses

Primary practice location

15547 N Reems Rd BLDG a
Surprise, AZ 85374-9583

Mailing address

15547 N Reems Rd BLDG a
Surprise, AZ 85374-9583
Phone (623) 535-9777

Other identifiers 3

IdentifierTypeStateIssuer
2663023MedicaidOH
3810005554MedicaidWV
401924MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000692 AZ Practitioner - Pain ManagementPractitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 1759312358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
University of Arizona College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Active Life Physical Medicine and Pain Center PLLCGroup PAC ID 0941350953, 4 clinicians

Practice addresses (Care Compare)

15547 N Reems Rd
BLDG a
Surprise, AZ 85374-9583
Phone (623) 535-9777

Merit-based Incentive Payment System (MIPS)

Final score
82.16 of 100Reported as group
Quality
88
Promoting interoperability
100
Improvement activities
40
Cost
52.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4116WVMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Active Life Physical Medicine and Pain Center, PLLC Pain Medicine CurrentSince May 17, 2009 Accepting new patients
Advanced Anesthesia, PLC CurrentSince Jun 1, 2016 Accepting new patients
Innovative Surgery Center PLC Current Accepting new patients
Pars Neurosurgical Associates, Inc Past Accepting new patients
Valley Neuromonitoring PLC PastSince Sep 1, 2019 Accepting new patients

Locations

3400 N Dysart Rd
Ste H131
Avondale, AZ 85392
Phone (623) 535-9777

13575 W Indian School Rd
Ste 7
Litchfield Park, AZ 85340

13575 W Indian School Rd
Ste 700
Litchfield Pk, AZ 85340
Phone (623) 935-5505

15547 N Reems Rd
#A
Surprise, AZ 85374

15547 N Reems Rd
Surprise, AZ 85374
Phone (623) 535-9777

15547 N Reems Rd
Bldg A
Surprise, AZ 85374
Phone (623) 535-9777

15547 N Reems Rd
Ste A
Surprise, AZ 85374
Phone (623) 535-9777

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBAIAA

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1801847546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15547 N REEMS RD BLDG A",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749583",
            "telephone_number": "623-535-9777",
            "fax_number": "623-236-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15547 N REEMS RD BLDG A",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749583",
            "telephone_number": "623-535-9777",
            "fax_number": "623-236-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "WENDI",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WV",
            "license": "4116",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "005097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2663023",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005554",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401924",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.