Garden State Pain Management, PA

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

GARDEN STATE PAIN MANAGEMENT, PA

Practice address

1033 Clifton Ave Ste 209
Clifton, NJ 07013-3525

Phone

(973) 473-5752

Fax

(973) 473-2459

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Todd S. Koppel, MDNPI 1932109170

Title

President

Phone

(973) 473-5752

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• Todd S. Koppel, MD

  • Pain Medicine (Anesthesiology) Physician
  • Clifton, NJ
  • NPI 1932109170

  NY

  Medicare reassignment Care Compare group Authorized official
• John Bogojovski, FNP-BC

  • Family Nurse Practitioner
  • Summit, NJ
  • NPI 1922877471
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697932800000",
    "number": "1265488902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE STE 209",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133525",
            "telephone_number": "973-473-5752",
            "fax_number": "973-473-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE STE 209",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133525",
            "telephone_number": "973-473-5752",
            "fax_number": "973-473-2459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Williamson St Ste 304",
            "address_purpose": "LOCATION",
            "city": "Elizabeth",
            "state": "NJ",
            "postal_code": "072023672",
            "country_code": "US",
            "telephone_number": "973-473-5752",
            "fax_number": "973-473-2459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GARDEN STATE PAIN MANAGEMENT, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A",
        "authorized_official_last_name": "KOPPEL",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-473-5752",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garcia Dental LLC
• Lauren Garcia, DMD
• Garden State Orthopaedic Associates, P.a.
• Garden State Pain Control Center
• Garden State Pain Control Center P.a.
• Garden State Spinal Care
• Garden State Spine and Pain Centers
• Garden State Sports & Pain Medicine, LLC
• Scott William Gardner, D.C.
• Michelle Gargiulo

• Pain Medicine (Anesthesiology) Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Pain Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2023; 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.