SV Pain Management PC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

209825 Issued in MA

Legal business name

SV PAIN MANAGEMENT PC

Practice address

171 Dwight Rd
Ste 102
Longmeadow, MA 01106-1673

Phone

(413) 754-3793

Fax

(413) 754-3467

NPI assigned

Jul 16, 2011

Organization subpart

No

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

Authorized official

Name

Thenu Manikantan, MDNPI 1366432668

Title

President

Phone

(413) 754-3793

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3451/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Thenu Manikantan, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • East Longmeadow, MA
  • NPI 1366432668
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1310774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319328000000",
    "number": "1124316724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 DWIGHT RD",
            "address_2": "STE 102",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061673",
            "telephone_number": "413-754-3793",
            "fax_number": "413-754-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 DWIGHT RD",
            "address_2": "STE 102",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061673",
            "telephone_number": "413-754-3793",
            "fax_number": "413-754-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SV PAIN MANAGEMENT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-16",
        "last_updated": "2011-10-23",
        "status": "A",
        "authorized_official_last_name": "MANIKANTAN",
        "authorized_official_first_name": "THENU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-754-3793",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MA",
            "license": "209825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Stephenson
• Andrew John Steplar, MA
• Halina Sullivan, PT
• John Warren Sullivan, MD
• Julia Sullivan
• Mark Sychtysz Jr.
• Zohal Taj
• Saman Tanveer
• Judith E Tapper, M.D.
• Reem Abbas Tarhini, PA-S

• Pain Medicine Physician in Longmeadow, MA
• Providers in Longmeadow, MA by specialty
• Pain Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2011; 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.