NPIMap

Organization Active NPI

Florida Pain & Rehabilitation Institute Inc

Doing business as Florida Pain and Rehabilitation Center

  • Interventional Pain Medicine Physician
  • Lady Lake, FL
National Provider Identifier
1154549905
Registry record updated Jul 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME109651 Issued in FL
Legal business name
FLORIDA PAIN & REHABILITATION INSTITUTE INC
Doing business as
Florida Pain and Rehabilitation Center
Practice address
918 Rolling Acres Rd Ste 102
Lady Lake, FL 32159-5027
Phone
(352) 751-6582
Fax
(866) 330-7528
NPI assigned
Apr 24, 2007
Last updated
Jul 6, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA PAIN AND REHABILITATION ASSOCIATES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2017

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

Authorized official

Name
Cherian Sajan, MDNPI 1174764153
Title
Owner
Phone
(407) 622-5766

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
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X ME109651 FL Primary

Addresses

Primary practice location

918 Rolling Acres Rd Ste 102
Lady Lake, FL 32159-5027

Mailing address

5365 W Atlantic Ave
Suite 504
Delray Beach, FL 33484-8172
Phone (561) 241-9300

Other identifiers 1

IdentifierTypeStateIssuer
4273890017OtherFLMEDICARE DME PROVIDER ID

Other names 1

  • Florida Pain and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170215002380 FL DME Supplier - Multi-Specialty - Physician 0749183606 Practice locations: Lady Lake, FL

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

National Provider Directory

National Provider Directory
Tax ID family
Florida Pain and Rehabilitation Institute Inc26 organizations share this tax ID, including this one
Part of
Florida Pain and Rehabilitation Associates Inc

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

880 Holcomb Bridge Rd
Ste 200
Roswell, GA 30076

Practitioners & affiliated clinicians

Practitioners 4

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": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499299200000",
    "number": "1154549905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5365 W ATLANTIC AVE",
            "address_2": "SUITE 504",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848172",
            "telephone_number": "561-241-9300",
            "fax_number": "561-241-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 ROLLING ACRES RD STE 102",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595027",
            "telephone_number": "352-751-6582",
            "fax_number": "866-330-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PAIN & REHABILITATION INSTITUTE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA PAIN AND REHABILITATION ASSOCIATES INC",
        "enumeration_date": "2007-04-24",
        "last_updated": "2017-07-06",
        "status": "A",
        "authorized_official_last_name": "SAJAN",
        "authorized_official_first_name": "CHERIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-622-5766",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME109651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME PROVIDER ID",
            "identifier": "4273890017",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Pain and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; 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.