NPIMap

Organization Active NPI

Ouch, PA

  • Specialist
  • St Augustine, FL
National Provider Identifier
1144383746
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OUCH, PA
Doing business as
PHYSICIANS PAIN CENTER
Practice address
105 Southpark Blvd
Suite C 300
St Augustine, FL 32086-4162
Phone
(904) 808-7246
Fax
(904) 808-7090
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Dr. Jyoti Patel, MDNPI 1801828553
Title
Partner
Phone
(904) 808-7246

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

105 Southpark Blvd
Suite C 300
St Augustine, FL 32086-4162

Mailing address

105 Southpark Blvd
Suite C 300
St Augustine, FL 32086-4162
Phone (904) 808-7246

Other identifiers 2

IdentifierTypeStateIssuer
7612385OtherFLAETNA
34189OtherFLBLUE CROSS BLUE SHIELD

Other names 1

  • PHYSICIANS PAIN CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913000583 FL Part B Supplier - Clinic/Group Practice 4082681747 Receives reassigned benefits from 10 practitioners
Practice locations: Paltaka, FL; Saint Augustine, FL; Jacksonville, FL

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
10D1107399Physicians Pain Center105 Southpark Blvd Ste C 300, Saint Augustine, FL 32086Certificate of waiverNov 4, 2027

National Provider Directory

National Provider Directory

Locations

12200 San Jose Blvd
Ste 10
Jacksonville, FL 32223
Phone 90480872465

105 Southpark Blvd
Ste C300
St Augustine, FL 32086
Phone (904) 797-2663

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1144383746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "SUITE C 300",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-808-7246",
            "fax_number": "904-808-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SOUTHPARK BLVD",
            "address_2": "SUITE C 300",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864162",
            "telephone_number": "904-808-7246",
            "fax_number": "904-808-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUCH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JYOTI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "904-808-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7612385",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34189",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHYSICIANS PAIN CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.