NPIMap

Organization Active NPI

Pain Physicians Anesthesia, LLC

  • Anesthesiology Physician
  • Alpharetta, GA
National Provider Identifier
1194287763
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PAIN PHYSICIANS ANESTHESIA, LLC
Practice address
3333 Old Milton Parkway, Suite 400
Alpharetta, GA 30005-4437
Phone
(770) 391-3979
Fax
(770) 391-0020
NPI assigned
Apr 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Authorized official

Name
Mr. Mohammed Shazad Wada, M.D.NPI 1477785186
Title
Member
Phone
(404) 273-6996

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

3333 Old Milton Parkway, Suite 400
Alpharetta, GA 30005-4437

Mailing address

3333 Old Milton Parkway, Suite 400
Alpharetta, GA 30005-4437
Phone (770) 391-3979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190724002940 GA Part B Supplier - Clinic/Group Practice 8426384736 Receives reassigned benefits from 25 practitioners
Practice locations: Alpharetta, GA

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554249600000",
    "number": "1194287763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 OLD MILTON PARKWAY, SUITE 400",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054437",
            "telephone_number": "770-391-3979",
            "fax_number": "770-391-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 OLD MILTON PARKWAY, SUITE 400",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054437",
            "telephone_number": "770-391-3979",
            "fax_number": "770-391-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN PHYSICIANS ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-04-03",
        "status": "A",
        "authorized_official_last_name": "WADA",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "SHAZAD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "404-273-6996",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.