MEDICARE: SUNSTATE REHAB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1366377558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSTATE REHAB

Provider Business Mailing Address
First Line	:	1417 N DUVAL
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85207-4327
Country	:	US
Telephone Number	:	480-447-0848
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 N DUVAL
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85207-4327
Country	:	US
Telephone Number	:	480-447-0848
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEREK HIGGINS
Credential	:	DO
Telephone Number	:	480-447-0848

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

Similar Medicare Providers

1700109618 — DR. BARBARA LAYNE JENNINGS DC
Practice Location Address:

4327 MESA VIEW LN
FORT COLLINS, CO
80526-3378

Practice Phone: 970-282-7706
Practice Fax: 970-223-2439

1396263158 — MR. LUIS MANUEL RIVERA JR. MS, LMT
Practice Location Address:

930 N MESA DR UNIT 2036
MESA, AZ
85201-4327

Practice Phone: 404-784-1233
Practice Fax:

1487413480 — DANIELLE EROSA LMT
Practice Location Address:

1521 E EMERALD AVE
MESA, AZ
85204-4327

Practice Phone: 602-582-8652
Practice Fax:

1568394476 — KAZHRA ANGELIQUE MAYAN KELCHO
Practice Location Address:

308 N 76TH PL
MESA, AZ
85207-7514

Practice Phone: 623-241-3886
Practice Fax:

1699771659 — CYNTHIA ANN PETERS CRNFA, FNP-C
Practice Location Address:

7165 E UNIVERSITY DR STE 183
MESA, AZ
85207-6415

Practice Phone: 480-668-5000
Practice Fax: 480-668-5065

1033116397 — MS. LAURIE L SHEPARD PT, OCS
Practice Location Address:

6836 E BROWN RD , STE 102
MESA, AZ
85207-3756

Practice Phone: 480-924-5514
Practice Fax: 480-924-5518

Directions to “SUNSTATE REHAB ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.