Organization Active NPI

Healthcare Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Old Bridge, NJ
National Provider Identifier
1235616509
Registry record updated Aug 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
25MA06154000 Issued in NJ
Legal business name
HEALTHCARE PAIN MANAGEMENT, LLC
Practice address
3 Hospital PLZ Ste 309
Old Bridge, NJ 08857
Phone
(732) 607-9000
Fax
(732) 607-7706
NPI assigned
Jul 19, 2018
Last updated
Aug 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2018

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

Authorized official

Name
Dr. Jacqueline Del Valle, M.D.NPI 1679560908
Title
President
Phone
(732) 607-9000

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
Interventional Pain Medicine Physician 208VP0014X 25MA06154000 NJ Primary

Addresses

Primary practice location

3 Hospital PLZ Ste 309
Old Bridge, NJ 08857

Mailing address

42 White Oak LN
Aberdeen, NJ 07747-1969
Phone (732) 607-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190829002133 NJ Part B Supplier - Clinic/Group Practice 9830427731 Receives reassigned benefits from 1 practitioner
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory

Locations

205 May St
Ste 202
Edison, NJ 08837
Phone (732) 416-8800

Practitioners & affiliated clinicians

Practitioners 2

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": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533427200000",
    "number": "1235616509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 WHITE OAK LN",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077471969",
            "telephone_number": "732-607-9000",
            "fax_number": "732-607-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HOSPITAL PLZ STE 309",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "08857",
            "telephone_number": "732-607-9000",
            "fax_number": "732-607-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-08-05",
        "status": "A",
        "authorized_official_last_name": "DEL VALLE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-607-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MA06154000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2018; 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.