Organization Active NPI

Metropolitan Pain Management Center Inc

  • Pain Medicine (Anesthesiology) Physician
  • Jacksonville, FL
National Provider Identifier
1215082532
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
METROPOLITAN PAIN MANAGEMENT CENTER INC
Practice address
4063 Salisbury Rd
Suite 206
Jacksonville, FL 32216-8030
Phone
(904) 296-3611
Fax
(904) 296-3617
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ismail D Salahi, MDNPI 1184688368
Title
President
Phone
(904) 296-3611

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

4063 Salisbury Rd
Suite 206
Jacksonville, FL 32216-8030

Mailing address

4063 Salisbury Rd
Suite 206
Jacksonville, FL 32216-8030
Phone (904) 296-3611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070326000412 FL Part B Supplier - Clinic/Group Practice 5496859779 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

3716 University Blvd S
Ste 1
Jacksonville, FL 32216
Phone (904) 296-3611

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215082532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4063 SALISBURY RD",
            "address_2": "SUITE 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168030",
            "telephone_number": "904-296-3611",
            "fax_number": "904-296-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 SALISBURY RD",
            "address_2": "SUITE 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168030",
            "telephone_number": "904-296-3611",
            "fax_number": "904-296-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN PAIN MANAGEMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALAHI",
        "authorized_official_first_name": "ISMAIL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-296-3611",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.