Interventional and Functional Pain Center

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

INTERVENTIONAL AND FUNCTIONAL PAIN CENTER

Practice address

1150 Reservoir Ave Ste 200
Cranston, RI 02920-6043

Phone

(401) 648-6100

NPI assigned

Sep 28, 2018

Organization subpart

No

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

Authorized official

Name

Juan Carlos Mirt

Title

Office Manager

Phone

(401) 648-6100

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Locations

Practitioners 4

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

• Blanki Cherubini, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Cranston, RI
  • NPI 1902232358

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jessica Lynae Parker, NP-C

  • Nurse Practitioner
  • Cranston, RI
  • NPI 1578985974
  Medicare reassignment Care Compare group NPD
• Christian Moneke-Obiekwe

  • Physician Assistant
  • Providence, RI
  • NPI 1366281289
  Medicare reassignment Care Compare group
• Sheila Marie Maguire, M.S.P.T.

  • Physical Therapist
  • Warwick, RI
  • NPI 1245441385
  Medicare reassignment NPD

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1164907804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 200",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206043",
            "telephone_number": "401-648-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 RESERVOIR AVE STE 200",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206043",
            "telephone_number": "401-648-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL AND FUNCTIONAL PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "MIRT",
        "authorized_official_first_name": "JUAN CARLOS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "401-648-6100"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Carl Impagliazzo, D.M.D.
• Inner Peace Counseling, LLC
• Institute for Behavioral Medicine
• Integrated Psychiatry Incorporated
• Internal Medicine Associates Inc
• Interventional and Functional Pain Center
• Interventional and Functional Pain Center
• Sofia Irons, LCSW
• Alexandra Maria Irving, LMFT
• Liza Marie Izzo

• Physical Medicine & Rehabilitation Physician in Cranston, RI
• Providers in Cranston, RI by specialty
• Physical Medicine & Rehabilitation Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.