Organization Active NPI

New York Pain Medicine Associate, PLLC

  • Interventional Pain Medicine Physician
  • Hempstead, NY
National Provider Identifier
1124696976
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
NEW YORK PAIN MEDICINE ASSOCIATE, PLLC
Practice address
717 Front St
Hempstead, NY 11550-4534
Phone
(732) 873-6868
Fax
(732) 873-6869
NPI assigned
Jun 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Hyesung Demesmin, PHARM.D.
Title
Authorized Representative
Phone
(732) 873-6868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

717 Front St
Hempstead, NY 11550-4534

Mailing address

59 Veronica Ave
Somerset, NJ 08873-3579
Phone (732) 873-6868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231129002875 NY Part B Supplier - Clinic/Group Practice 6103274246 Receives reassigned benefits from 3 practitioners
Practice locations: Hempstead, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1124696976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 VERONICA AVE",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733579",
            "telephone_number": "732-873-6868",
            "fax_number": "732-862-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 FRONT ST",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115504534",
            "telephone_number": "732-873-6868",
            "fax_number": "732-873-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PAIN MEDICINE ASSOCIATE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "DEMESMIN",
        "authorized_official_first_name": "HYESUNG",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "732-873-6868",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.