LA PLATA PHYSICAL MEDICINE PC – Physical Medicine & Rehabilitation Physician, NPI 1689137754

LA PLATA PHYSICAL MEDICINE PC is a healthcare provider. based in Durango, Colorado. specializing in Physical Medicine & Rehabilitation Physician. The NPI Number for LA PLATA PHYSICAL MEDICINE PC is 1689137754

Main info

Organization
Name
LA PLATA PHYSICAL MEDICINE PC
NPI
1689137754
Phone
(970) 403-3324
Address
555 RIVERGATE STE B1-102
Authorized Official
ROBERT S WALLACH OWNER DO
Enumeration Date
7 April 2019
Last Update Date
8 October 2024
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness75
Years active:7State licenses:0Digital endpointsOther names

Provider Addresses for LA PLATA PHYSICAL MEDICINE PC

  • 555 RIVERGATE STE B1-102

    DURANGO, CO 813017470

    Phone: (970) 403-3324

    Fax: (970) 232-2075

    Type: Mailing

  • 555 RIVERGATE LN STE B1-101

    DURANGO, CO 813017470

    Phone: (970) 403-3324

    Fax: (833) 975-0954

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-06-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-10-31 (223 days ago).

Enrollment records

1

Earliest due date

2025-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20190612001861OClinic/Group PracticeCO2025-10-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 81301)

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Reviews

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Frequently asked questions

What number should I use to identify LA PLATA PHYSICAL MEDICINE PC for billing?
Administrative and clinical systems typically use NPI 1689137754 for LA PLATA PHYSICAL MEDICINE PC.
Does the public listing show LA PLATA PHYSICAL MEDICINE PC as active?
LA PLATA PHYSICAL MEDICINE PC's NPI record reflects an active status in NPPES.
What type of care does LA PLATA PHYSICAL MEDICINE PC provide?
LA PLATA PHYSICAL MEDICINE PC's profile centers on Physical Medicine & Rehabilitation Physician. Clinical services aligned with this taxonomy classification.
What city is tied to LA PLATA PHYSICAL MEDICINE PC?
The directory associates LA PLATA PHYSICAL MEDICINE PC with Durango, Colorado. Check all listed addresses for suites or satellite offices.
Can I export LA PLATA PHYSICAL MEDICINE PC's record?
You can download the official NPPES record; we summarize key fields for readability.

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