Organization Active NPI

New York Spine and Pain Management, P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Howard Beach, NY
National Provider Identifier
1154427359
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
NEW YORK SPINE AND PAIN MANAGEMENT, P.C.
Practice address
15144 82ND St
Howard Beach, NY 11414-1777
Phone
(718) 738-2550
Fax
(718) 738-6644
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Dr. Glenn Goldstein, D.O.
Title
President
Phone
(718) 738-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X NY Primary

Addresses

Primary practice location

15144 82ND St
Howard Beach, NY 11414-1777

Mailing address

15144 82ND St
Howard Beach, NY 11414-1777
Phone (718) 738-2550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061018000446 NY Part B Supplier - Clinic/Group Practice 9335145184 Receives reassigned benefits from 1 practitioner
Practice locations: Howard Beach, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1154427359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15144 82ND ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141777",
            "telephone_number": "718-738-2550",
            "fax_number": "718-738-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15144 82ND ST",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114141777",
            "telephone_number": "718-738-2550",
            "fax_number": "718-738-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK SPINE AND PAIN MANAGEMENT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-738-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.