Spine Sports & Interventional Pain Medicine PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SPINE SPORTS & INTERVENTIONAL PAIN MEDICINE PC

Practice address

186 Montague St
Brooklyn, NY 11201-3634

Phone

(718) 358-1700

Fax

(718) 489-4101

NPI assigned

Jul 7, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Sanjeev Agarwal, MDNPI 1154487528

Title

Owner

Phone

(631) 486-9100

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Sanjeev Agarwal MD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sanjeev Agarwal MD PC

  • Specialist
  • Flushing, NY
  • NPI 1952614661
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sanjeev Agarwal, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Brooklyn, NY
  • NPI 1154487528

  NY

  Medicare reassignment Authorized official
• Robert Parcon Ticzon

  • Physical Therapist
  • Hillside, NJ
  • NPI 1184970329

  NY

  Medicare reassignment
• Chhavi Agarwal, MD

  • Pediatric Endocrinology Physician
  • Scarsdale, NY
  • NPI 1053407700
  NPD (past)
• Resmy Palliyil Gopi

  • Pediatric Endocrinology Physician
  • Allentown, PA
  • NPI 1356602924
  NPD (past)

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1043626435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 CENTRAL PARK AVE",
            "address_2": "SUITE 303",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105831068",
            "telephone_number": "914-713-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 MONTAGUE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013634",
            "telephone_number": "718-358-1700",
            "fax_number": "718-489-4101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Central Park Ave",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105831068",
            "country_code": "US",
            "telephone_number": "914-713-8774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPINE SPORTS & INTERVENTIONAL PAIN MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "SANJEEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-486-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NY",
            "license": "2439891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02899925",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joann Michelle Spina
• John H Spina, DPM
• Kelly Spina, LMSW
• Spinal Chiropractic PC
• Spine and Pain Consultant, PLLC
• Carol A Spinella, RNC
• Joann Spinella
• Anthony Spinelli, D.D.S
• Beatrice A Spinelli, M.D.
• Christopher M Spinelli, MD

• Physical Medicine & Rehabilitation Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.