Pisa ASC Holdco LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PISA ASC HOLDCO LLC

Doing business as

Pain Institute of Southern Arizona Procedure Center

Practice address

4741 E Camp Lowell Drive
Tucson, AZ 85712

Phone

(520) 318-6035

Fax

(520) 795-9953

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Greg Turk

Title

Director/Officer

Phone

(520) 333-7730

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pain Institute of Southern Arizona Procedure Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Pain Institute of Southern Arizona Procedure CenterCCN 03C0001403

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

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

• Banner Health

  dba Banner Casa Grande Medical Center

  • General Acute Care Hospital
  • Casa Grande, AZ
  • NPI 1003232976

  Member Of

  NPD member

Locations

Practitioners 10

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.

• Christopher Harold Bailey, M.D.

  • Pain Medicine Physician
  • Tucson, AZ
  • NPI 1871989301
  Medicare reassignment NPD
• Eric G Cornidez, M.D.

  • Pain Medicine Physician
  • Tucson, AZ
  • NPI 1679792527
  Medicare reassignment NPD
• Efrain Israel Cubillo IV, MD

  • Pain Medicine (Anesthesiology) Physician
  • Tucson, AZ
  • NPI 1750675864
  Medicare reassignment NPD
• Marco Duran, MD

  • Pain Medicine Physician
  • Tucson, AZ
  • NPI 1043605066
  Medicare reassignment NPD
• Nicholas Elkins, D.O.

  • Pain Medicine Physician
  • Safford, AZ
  • NPI 1780092346
  Medicare reassignment NPD
• Kayven M Farshad, MD

  • Pain Medicine (Anesthesiology) Physician
  • Tucson, AZ
  • NPI 1841678307
  Medicare reassignment NPD
• Jared Gilman, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Tucson, AZ
  • NPI 1801240569
  Medicare reassignment NPD
• Kenneth B Gossler, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Tucson, AZ
  • NPI 1942292628
  Medicare reassignment NPD
• Melissa Jessica Seelbach, M.D., PH.D

  • Pain Medicine (Anesthesiology) Physician
  • Grand Forks, ND
  • NPI 1356786354

  AZ

  Medicare reassignment NPD
• Todd C. Case, M.D.

  • Plastic Surgery Physician
  • Tucson, AZ
  • NPI 1942355805
  NPD (past)

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1174185649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 E CAMP LOWELL DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121256",
            "telephone_number": "520-829-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 E CAMP LOWELL DRIVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-318-6035",
            "fax_number": "520-795-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PISA ASC HOLDCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "TURK",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "520-333-7730"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003149",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Institute of Southern Arizona Procedure Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Royal Mansukhlal Pipaliya, MD
• Wendy W Pipentacos, MSW, LCSW
• Lorraine Pipkin, NP
• Mary Elizabeth (Beth) Piraino, DNP
• Mark Farris Pirtle, D.P.T.
• Michael A Pischke
• Susan Marie Pistawka
• Monica Cecelia Pita
• Megan Marie Pitman
• Mary Michelle Pitot, EDD, LCSW

• Ambulatory Surgical Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.