NPIMap

Organization Active NPI

Pain Consultants of West Florida P a

  • Interventional Pain Medicine Physician
  • Pensacola, FL
National Provider Identifier
1013074897
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAIN CONSULTANTS OF WEST FLORIDA P A
Practice address
4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone
(850) 494-0000
Fax
(850) 494-0001
NPI assigned
Jan 2, 2007
Last updated
Aug 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Authorized official

Name
Pablo ConcepcionNPI 1043232432
Title
Owner/Physician
Phone
(850) 494-0000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

4624 N Davis Hwy
Pensacola, FL 32503-2337

Mailing address

4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone (850) 494-0000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@pcofwfla.e-mdsdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040506000982 FL Part B Supplier - Clinic/Group Practice 3274522206 Receives reassigned benefits from 6 practitioners
Practice locations: Pensacola, FL
O20101201000693 FL DME Supplier - Physician - Anesthesiology 3274522206 Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

1034 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 344-1646

911 Mar Walt Dr
#A
Ft Walton Bch, FL 32547
Phone (850) 862-4001

5028 N Davis Hwy
Pensacola, FL 32503

5102 N Davis Hwy
Pensacola, FL 32503
Phone (850) 484-8800

Interoperability endpoints

  • Direct secure messaging: admin@pcofwfla.e-mdsdirect.com

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1013074897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-494-0000",
            "fax_number": "850-494-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-494-0000",
            "fax_number": "850-494-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CONSULTANTS OF WEST FLORIDA P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "CONCEPCION",
        "authorized_official_first_name": "PABLO",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "850-494-0000"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@pcofwfla.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "4624 N Davis Hwy",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325032337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.