NPIMap

Organization Active NPI

Centers of Rehabilitation & Pain Medicine Inc

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Placentia, CA
National Provider Identifier
1184933830
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
A86192 Issued in CA
Legal business name
CENTERS OF REHABILITATION & PAIN MEDICINE INC
Practice address
1041 E Yorba Linda Blvd Ste 210
Placentia, CA 92870-3763
Phone
(714) 223-7000
Fax
(833) 471-2059
NPI assigned
Sep 29, 2010
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Shane Speirs, MDNPI 1427589498
Title
President/Cmo
Phone
(480) 495-5485

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A86192 CA Primary

Addresses

Primary practice location

1041 E Yorba Linda Blvd Ste 210
Placentia, CA 92870-3763

Mailing address

840 E McKellips Rd Ste 105
Mesa, AZ 85203-9654
Phone (602) 491-0701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110119000202 CA Part B Supplier - Clinic/Group Practice 9830378124 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
Practice locations: Orange, CA; Placentia, CA; Irvine, CA; Laguna Hills, CA; Foothill Ranch, CA

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 12

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": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1184933830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E MCKELLIPS RD STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852039654",
            "telephone_number": "602-491-0701",
            "fax_number": "480-631-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 E YORBA LINDA BLVD STE 210",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703763",
            "telephone_number": "714-223-7000",
            "fax_number": "833-471-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERS OF REHABILITATION & PAIN MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2023-10-09",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "SPEIRS",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PRESIDENT/CMO",
        "authorized_official_telephone_number": "480-495-5485",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A86192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.