Active NPI
Spinal Care Pain Associates, P.C.
- Interventional Pain Medicine Physician
- Philadelphia, PA
National Provider Identifier
1245306489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- Legal business name
- SPINAL CARE PAIN ASSOCIATES, P.C.
- Practice address
- 2410 S Broad St
3Rd Floor
Philadelphia, PA 19145-4418 - Phone
- (215) 462-6600
- Fax
- (215) 462-2650
- NPI assigned
- Nov 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Glenn Miller, M.D.
- Title
- Medical Director
- Phone
- (215) 462-6600
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | Primary |
Addresses
Primary practice location
2410 S Broad St
3Rd Floor
Philadelphia, PA 19145-4418
Mailing address
2410 S Broad St
3Rd Floor
Philadelphia, PA 19145-4418
Phone (215) 462-6600
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2992866 | Other | PA | AETNA |
| 2100648000 | Other | PA | KEYSTONE EAST |
| 30001785 | Other | PA | KEYSTONE MERCY |
| 347886100 | Other | PA | US DEPT OF LABOR OWCP |
| 22210 | Other | PA | HEALTH PARTNERS |
| 1413937 | Other | PA | ALL BLUE SHIELDS, AMERIHL |
| 93900 | Other | PA | AMERICHOICE OF PENN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040615000715 | PA | Part B Supplier - Clinic/Group Practice | 2264416544 |
Receives reassigned benefits from 6 practitioners Practice locations: Philadelphia, PA |
National Provider Directory
National Provider Directory- Tax ID family
- Spinal Care Pain Associates P C
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Certified Registered Nurse Anesthetist
- Phila, PA
- NPI 1982768362
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Mullica Hill, NJ
- NPI 1831476639
PA
-
- Physician Assistant
- Philadelphia, PA
- NPI 1689993339
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1245306489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 S BROAD ST",
"address_2": "3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191454418",
"telephone_number": "215-462-6600",
"fax_number": "215-462-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 S BROAD ST",
"address_2": "3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191454418",
"telephone_number": "215-462-6600",
"fax_number": "215-462-2650"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPINAL CARE PAIN ASSOCIATES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-28",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "GLENN",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "215-462-6600",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2992866",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE EAST",
"identifier": "2100648000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "30001785",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR OWCP",
"identifier": "347886100",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "22210",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALL BLUE SHIELDS, AMERIHL",
"identifier": "1413937",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE OF PENN",
"identifier": "93900",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
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.