NPIMap

Organization Active NPI

Advanced Pain Diagnostic & Solutions, Inc.

  • Pain Clinic/Center
  • Yuba City, CA
National Provider Identifier
1124547559
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Practice address
480 Del Norte Ave
Yuba City, CA 95991-4125
Phone
(916) 953-7571
Fax
(916) 771-8515
NPI assigned
Sep 18, 2017
Last updated
Jun 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED PAIN DIAGNOSTICS & SOLUTIONS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Kayvan Haddadan, MDNPI 1538127832
Title
President & Chairman
Phone
(415) 786-6192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

480 Del Norte Ave
Yuba City, CA 95991-4125

Mailing address

729 Sunrise Ave Ste 602
Roseville, CA 95661-4542
Phone (916) 953-7571

Other names 1

  • Kayvan D. Haddadan, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120511000538 CA Part B Supplier - Clinic/Group Practice 2264695196 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA; Yuba City, CA; Folsom, CA; Rocklin, CA; Roseville, CA; Davis, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2178230Advanced Pain Diagnostic & Solutions480 Del Norte Avenue, Yuba City, CA 95991Certificate of waiverJan 28, 2028

National Provider Directory

National Provider Directory
Part of
Advanced Pain Diagnostic S

Locations

729 Sunrise Ave
Ste 602
Roseville, CA 95661
Phone (916) 781-7882

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1124547559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 SUNRISE AVE STE 602",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614542",
            "telephone_number": "916-953-7571",
            "fax_number": "916-771-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 DEL NORTE AVE",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959914125",
            "telephone_number": "916-953-7571",
            "fax_number": "916-771-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED PAIN DIAGNOSTICS & SOLUTIONS, INC.",
        "enumeration_date": "2017-09-18",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "HADDADAN",
        "authorized_official_first_name": "KAYVAN",
        "authorized_official_title_or_position": "PRESIDENT & CHAIRMAN",
        "authorized_official_telephone_number": "415-786-6192",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kayvan D. Haddadan, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Kayvan D. Haddadan, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Yuba City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.