NPIMap

Organization Active NPI

Novaspine Pain Institute, PLC

  • Pain Medicine Physician
  • Sun City West, AZ
National Provider Identifier
1154745263
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
42990 Issued in AZ
Legal business name
NOVASPINE PAIN INSTITUTE, PLC
Practice address
14300 W Granite Valley Dr Ste A1
Sun City West, AZ 85375-5797
Phone
(623) 777-4747
Fax
(623) 777-4748
NPI assigned
Feb 10, 2014
Last updated
Feb 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Dr. Clifford T Baker, M.D.NPI 1235342775
Title
Owner
Phone
(623) 777-4747

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 42990 AZ
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 42990 AZ
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X 42990 AZ
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 42990 AZ Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X 42990 AZ
Durable Medical Equipment & Medical Supplies 332B00000X 42990 AZ

Addresses

Primary practice location

14300 W Granite Valley Dr Ste A1
Sun City West, AZ 85375-5797

Mailing address

PO Box 5068
Sun City West, AZ 85376-5068
Phone (623) 777-4747

Other practice location 1

13203 N 103rd Ave Ste H5
Sun City, AZ 85351-3032
Phone (623) 777-4747

Other practice location 2

17100 N 67th Ave Ste 300
Glendale, AZ 85308-3657
Phone (623) 777-4747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140630000941 AZ Part B Supplier - Clinic/Group Practice 9931323359 Receives reassigned benefits from 39 practitioners
Practice locations: Glendale, AZ; Sun City, AZ; Sun City West, AZ

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory

Locations

1684 E Boston St
Ste 101
Gilbert, AZ 85295
Phone (480) 899-4420

14510 W Shumway Dr
Ste 201
Sun City West, AZ 85375
Phone (623) 444-6463

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1154745263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5068",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853765068",
            "telephone_number": "623-777-4747",
            "fax_number": "623-777-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 W GRANITE VALLEY DR STE A1",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755797",
            "telephone_number": "623-777-4747",
            "fax_number": "623-777-4748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13203 N 103rd Ave Ste H5",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513032",
            "country_code": "US",
            "telephone_number": "623-777-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17100 N 67th Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853083657",
            "country_code": "US",
            "telephone_number": "623-777-4747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVASPINE PAIN INSTITUTE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-777-4747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "42990",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "42990",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "42990",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "AZ",
            "license": "42990",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AZ",
            "license": "42990",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "42990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.