ANZA WELLNESS & RECOVERY – Addiction Medicine (Psychiatry & Neurology) Physician, NPI 1811605637
Addiction Medicine (Psychiatry & Neurology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ANZA WELLNESS & RECOVERY
5609 Auburn Way S
Auburn, WA 980927348
Phone: (480) 999-8200
Fax: (480) 800-2212
Type: Location
402 S 333rd St Ste 117
Federal Way, WA 980037099
Phone: (424) 480-2322
Type: Location
15150 W Park Pl Ste 2031
Goodyear, AZ 853952385
Phone: (424) 480-5230
Type: Location
703 Walnut St
Boulder, CO 803025032
Phone: (480) 999-8200
Fax: (480) 800-2212
Type: Location
350 E COMMERCIAL RD
SUITE 112
SAN BERNARDINO, CA 924083764
Phone: (480) 999-8200
Fax: (480) 800-2212
Type: Mailing
350 E. COMMERCIAL RD
SUITE 112
SAN BERNARDINO, CA 924083764
Phone: (480) 999-8200
Fax: (480) 800-2212
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: 2025-04-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20231204001463 | O | Clinic/Group Practice | CA | TBD |
| O20241125002578 | O | Clinic/Group Practice | CO | TBD |
| O20250429000484 | O | Clinic/Group Practice | WA | TBD |
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.
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 98092)
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