Innovative Pain Management, LLC

Primary specialty

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

Legal business name

INNOVATIVE PAIN MANAGEMENT, LLC

Practice address

199 Main St
2ND FL
Keansburg, NJ 07734-1734

Phone

(732) 495-0777

Fax

(732) 495-1009

NPI assigned

Oct 6, 2010

Organization subpart

No

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

Authorized official

Name

Gary L Yen, MD

Title

Owner

Phone

(732) 495-0777

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Robert D Boyd, D.O

  • Family Medicine Physician
  • Woodbridge, NJ
  • NPI 1548474257
  NPD (past)
• Justin B. Wilson, M.D. FACP

  • Internal Medicine Physician
  • Morris Plains, NJ
  • NPI 1831161850
  NPD (past)
• Robert Peter Luca, DC

  • Chiropractor
  • Middletown, NY
  • NPI 1609826189
  NPD (past)

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1215246459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 MAIN ST",
            "address_2": "2ND FL",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341734",
            "telephone_number": "732-495-0777",
            "fax_number": "732-495-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 MAIN ST",
            "address_2": "2ND FL",
            "city": "KEANSBURG",
            "state": "NJ",
            "postal_code": "077341734",
            "telephone_number": "732-495-0777",
            "fax_number": "732-495-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "YEN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-495-0777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Ann Gazerwitz, PHARMD
• Paul Dana Georgiou, PT
• Lorraine Hanson
• Patrice Chanel Harding, MS, BCBA, NJ-LBA
• Colleen Harrell, LCSW
• Roxie J Jackson, PTA
• Ricky Ricardo Jamison Jr.
• Heymin Jeong, RPH, PHARMD
• Trivikram Kanumuri
• Susan M Karl, PHYSICAL THERAPIST

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Keansburg, NJ
• Providers in Keansburg, NJ by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.