Pain Treatment Centers of Maryland, LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

PAIN TREATMENT CENTERS OF MARYLAND, LLC

Practice address

116 Westminster Pike
Suite 106
Reisterstown, MD 21136-1027

Phone

(410) 833-1011

Fax

(410) 833-1680

NPI assigned

Mar 22, 2015

Last updated

Jan 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tatyana Reznikov, MDNPI 1982819421

Title

MBR

Phone

(410) 833-1101

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Tatyana Reznikov, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Reisterstown, MD
  • NPI 1982819421
  Medicare reassignment NPD Authorized official
• Mary Martelloni

  • Licensed Practical Nurse
  • Cape Coral, FL
  • NPI 1023503794
  NPD

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454025600000",
    "number": "1174917736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WESTMINSTER PIKE",
            "address_2": "SUITE 106",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361027",
            "telephone_number": "410-833-1011",
            "fax_number": "410-833-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 WESTMINSTER PIKE",
            "address_2": "SUITE 106",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361027",
            "telephone_number": "410-833-1011",
            "fax_number": "410-833-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN TREATMENT CENTERS OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-22",
        "last_updated": "2016-01-29",
        "status": "A",
        "authorized_official_last_name": "REZNIKOV",
        "authorized_official_first_name": "TATYANA",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "410-833-1101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "130198",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "512314300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adedoyin Olufuwa
• Daniel Thomas Ontko, PT
• Optimum Surgical Services, LLC
• Kehinde Oyekan, CPMHNP
• Danielle Page
• Mini Abraham Panikar, M.D.
• Elizabeth Fell Pauldine, CRNP
• Shantel Payne
• Zuri Pearce Battle
• Pediatrics at Chartley PA

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.