NPIMap

Organization Active NPI

Pain Management Consultants a Professional Medical Corporation

Doing business as Pacific Pain Medicine Consultants

  • Pain Medicine Physician
  • Oceanside, CA
National Provider Identifier
1023065646
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
G47938 Issued in CA
Legal business name
PAIN MANAGEMENT CONSULTANTS A PROFESSIONAL MEDICAL CORPORATION
Doing business as
Pacific Pain Medicine Consultants
Practice address
3998 Vista Way Ste 108
Oceanside, CA 92056
Phone
(760) 753-1104
Fax
(760) 943-6494
NPI assigned
May 28, 2006
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Candace Irons
Title
Business Manager
Phone
(760) 753-1104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X G47938 CA Primary

Addresses

Primary practice location

3998 Vista Way Ste 108
Oceanside, CA 92056

Mailing address

477 N. El Camino Real
Suite B301
Encinitas, CA 92024
Phone (760) 753-1104

Other practice location 1

477 N. El Camino Real
Suite B301
Encinitas, CA 92024
Phone (760) 753-1104

Other names 1

  • Pacific Pain Medicine Consultants Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426001839 CA Part B Supplier - Clinic/Group Practice 3173510807 Receives reassigned benefits from 9 practitioners
Practice locations: Encinitas, CA; Oceanside, CA

National Provider Directory

National Provider Directory

Locations

320 Santa Fe Dr
Ste 309
Encinitas, CA 92024
Phone (760) 753-1104

477 N El Camino Real
Ste 3
Encinitas, CA 92024

3998 Vista Way
Ste C108
Oceanside, CA 92056
Phone (760) 643-1622

3998 Vista Way
Ste C110
Oceanside, CA 92056
Phone (760) 491-7336

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1023065646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N. EL CAMINO REAL",
            "address_2": "SUITE B301",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-753-1104",
            "fax_number": "760-943-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 VISTA WAY STE 108",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92056",
            "telephone_number": "760-753-1104",
            "fax_number": "760-943-6494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "477 N. El Camino Real",
            "address_2": "Suite B301",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "92024",
            "country_code": "US",
            "telephone_number": "760-753-1104",
            "fax_number": "760-943-6494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN MANAGEMENT CONSULTANTS A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "IRONS",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "760-753-1104"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G47938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Pain Medicine Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pacific Pain Medicine Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.