NPIMap

Organization Active NPI

Commonwealth Pain Associates, PLLC

Doing business as Commonwealth Pain & Spine

  • Durable Medical Equipment & Medical Supplies
  • New Albany, IN
National Provider Identifier
1225544885
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
COMMONWEALTH PAIN ASSOCIATES, PLLC
Doing business as
Commonwealth Pain & Spine
Practice address
3602 Northgate CT Ste 39
New Albany, IN 47150-6417
Phone
(812) 670-5684
Fax
(812) 941-0814
NPI assigned
Dec 19, 2017
Last updated
Dec 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Authorized official

Name
Jason Carnes Lewis, MDNPI 1720127913
Title
Owner
Phone
(502) 855-7200

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
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3602 Northgate CT Ste 39
New Albany, IN 47150-6417

Mailing address

13000 Equity PL Ste 203
Louisville, KY 40223-3979
Phone (502) 907-0356

Other identifiers 2

IdentifierTypeStateIssuer
201287400CMedicaidIN
IN2373OtherINMEDICARE PTAN

Other names 1

  • Commonwealth Pain & Spine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180426002959 IN DME Supplier - Physician - Interventional Pain Management 0941441919 Practice locations: New Albany, IN

Other NPIs with the same Medicare PAC ID 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Pain Spine38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Practitioners & affiliated clinicians

Practitioners 1

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": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1225544885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 EQUITY PL STE 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233979",
            "telephone_number": "502-907-0356",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 NORTHGATE CT STE 39",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471506417",
            "telephone_number": "812-670-5684",
            "fax_number": "812-941-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH PAIN ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CARNES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-855-7200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201287400C",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IN2373",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Pain & Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.