Active NPI
Interventional Pain & Spine Center PLLC
- Pain Medicine (Psychiatry & Neurology) Physician
- Wexford, PA
National Provider Identifier
1114768843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Psychiatry & Neurology) Physician
- Legal business name
- INTERVENTIONAL PAIN & SPINE CENTER PLLC
- Practice address
- 100 Bradford Road
Ste 410
Wexford, PA 15090-8489 - Phone
- (724) 965-8946
- Fax
- (724) 965-8953
- NPI assigned
- Jun 5, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mohammad Khizar Ali, MD
- Title
- Authorized Official
- Phone
- (724) 965-8946
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neurophysiology Physician | 2084N0600X | |||
| Pain Medicine (Psychiatry & Neurology) Physician | 2084P2900X | Primary | ||
| Interventional Pain Medicine Physician | 208VP0014X |
Addresses
Primary practice location
100 Bradford Road
Ste 410
Wexford, PA 15090-8489
Mailing address
100 Bradford Road
Ste 410
Wexford, PA 15090-8489
Phone (724) 965-8946
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
217 N Jefferson St
Ste C
New Castle, PA 16101
100 Bradford Rd
Ste 410
Wexford, PA 15090
Phone (724) 719-2441
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIIFDD
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Medical Physician Assistant
- Wexford, PA
- NPI 1609538115
-
- Allergy & Immunology Physician
- Wexford, PA
- NPI 1174559561
-
- Allergy & Immunology Physician
- Murrysville, PA
- NPI 1811935059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717545600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726012800000",
"number": "1114768843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BRADFORD ROAD",
"address_2": "STE 410",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150908489",
"telephone_number": "724-965-8946",
"fax_number": "724-965-8953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BRADFORD ROAD",
"address_2": "STE 410",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150908489",
"telephone_number": "724-965-8946",
"fax_number": "724-965-8953"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERVENTIONAL PAIN & SPINE CENTER PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-05",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A",
"authorized_official_last_name": "ALI",
"authorized_official_first_name": "MOHAMMAD",
"authorized_official_middle_name": "KHIZAR",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "724-965-8946",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084N0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Pain Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208VP0014X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wexford, PA
- Sarah Patricia Ignelzi, RN
- Oluyemisi B Ijose, R.PH
- Joseph Imbriglia, MD
- Innovative Family Wellness LLC
- Integrated Group Practice Pennsylvania, P.C. (Urology Specialists of America)
- Invision Customized Services
- Invision Integrated Behavioral Health
- Chiarina M Iregui
- Simon Ikechukwu Iroha
- Valentyna Ivanova, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.