Organization Active NPI

Neurology and Pain Medical Associates LLC

  • Neurology Physician
  • Lafayette, IN
National Provider Identifier
1265996144
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGY AND PAIN MEDICAL ASSOCIATES LLC
Practice address
130 Professional CT Ste D
Lafayette, IN 47905-5153
Phone
(765) 446-8888
Fax
(219) 866-7001
NPI assigned
Jan 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Authorized official

Name
Julian Ungar-Sargon, MD
Title
Owner
Phone
(219) 866-7222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X

Addresses

Primary practice location

130 Professional CT Ste D
Lafayette, IN 47905-5153

Mailing address

123 S McKinley Ave
Rensselaer, IN 47978-2949
Phone (219) 866-7222

Other identifiers 1

IdentifierTypeStateIssuer
01040129AOtherINMEDICAL LICESNE

National Provider Directory

National Provider Directory

Locations

130 Professional Ct
Lafayette, IN 47905
Phone (219) 588-8000

130 Professional Ct
#D
Lafayette, IN 47905
Phone (219) 756-0400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1548374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1265996144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S MCKINLEY AVE",
            "city": "RENSSELAER",
            "state": "IN",
            "postal_code": "479782949",
            "telephone_number": "219-866-7222",
            "fax_number": "219-866-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PROFESSIONAL CT STE D",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055153",
            "telephone_number": "765-446-8888",
            "fax_number": "219-866-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY AND PAIN MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-25",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "UNGAR-SARGON",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-866-7222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICESNE",
            "identifier": "01040129A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.