SURPRISE LAKE CHIROPRACTIC, INC PC – Chiropractor, NPI 1528843612

SURPRISE LAKE CHIROPRACTIC, INC PC is a healthcare provider. based in Puyallup, Washington. specializing in Chiropractor. The NPI Number for SURPRISE LAKE CHIROPRACTIC, INC PC is 1528843612

Main info

Organization
Name
SURPRISE LAKE CHIROPRACTIC, INC PC
NPI
1528843612
Phone
(253) 952-0302
Address
PO BOX 1166
Authorized Official
DR. JENNIE BONFIGLIO OWNER DC
Enumeration Date
28 August 2023
Last Update Date
13 March 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

Provider Addresses for SURPRISE LAKE CHIROPRACTIC, INC PC

  • PO BOX 1166

    PUYALLUP, WA 983710228

    Phone: (253) 952-0302

    Fax: (253) 952-0307

    Type: Mailing

  • 724 MERIDIAN E STE 1

    MILTON, WA 983549391

    Phone: (253) 952-0302

    Fax: (253) 952-0307

    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: 2024-04-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

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
O20240409004497OClinic/Group PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

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 98371)

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Reviews

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Frequently asked questions

Does SURPRISE LAKE CHIROPRACTIC, INC PC share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SURPRISE LAKE CHIROPRACTIC, INC PC uses 1528843612.
Does CMS list SURPRISE LAKE CHIROPRACTIC, INC PC as active?
Yes — SURPRISE LAKE CHIROPRACTIC, INC PC is active in the NPI listing used on this page.
What is SURPRISE LAKE CHIROPRACTIC, INC PC's primary classification?
Chiropractor is the headline specialty for SURPRISE LAKE CHIROPRACTIC, INC PC here. Clinical services aligned with this taxonomy classification.
Where is SURPRISE LAKE CHIROPRACTIC, INC PC based?
SURPRISE LAKE CHIROPRACTIC, INC PC is tied to Puyallup, Washington in the data we show; additional addresses may exist on the full record.
Is the information about SURPRISE LAKE CHIROPRACTIC, INC PC up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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