NPIMap

Organization Active NPI

Professional Pain Management Services PA

  • Interventional Pain Medicine Physician
  • Clifton, NJ
National Provider Identifier
1194036111
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
25MA06850700 Issued in NJ
Legal business name
PROFESSIONAL PAIN MANAGEMENT SERVICES PA
Practice address
1060 Clifton Ave
Clifton, NJ 07013-3638
Phone
(973) 779-7361
Fax
(973) 779-7385
NPI assigned
Jun 24, 2010
Last updated
Jun 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Dr. Ravi K Venkataraman, MDNPI 1194755173
Title
Ceo
Phone
(973) 779-7361

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 25MA06850700 NJ Primary

Addresses

Primary practice location

1060 Clifton Ave
Clifton, NJ 07013-3638

Mailing address

PO Box 1258
Clifton, NJ 07012-0758
Phone (973) 779-7361

National Provider Directory

National Provider Directory

Locations

89 Sparta Ave
Ste 250
Sparta, NJ 07871
Phone (201) 265-8071

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1194036111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1258",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070120758",
            "telephone_number": "973-779-7361",
            "fax_number": "973-779-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133638",
            "telephone_number": "973-779-7361",
            "fax_number": "973-779-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PAIN MANAGEMENT SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-24",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "VENKATARAMAN",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-779-7361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA06850700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.