Organization Active NPI

Pain Release Center a Professional Corporation

  • Interventional Pain Medicine Physician
  • Studio City, CA
National Provider Identifier
1275280075
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAIN RELEASE CENTER A PROFESSIONAL CORPORATION
Practice address
12215 Ventura Blvd Ste 208
Studio City, CA 91604-2521
Phone
(818) 505-0816
Fax
(818) 392-5092
NPI assigned
Mar 2, 2022
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Savita Kanji
Title
Clinical Director
Phone
(805) 890-8001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

12215 Ventura Blvd Ste 208
Studio City, CA 91604-2521

Mailing address

12215 Ventura Blvd Ste 208
Studio City, CA 91604-2521
Phone (818) 505-0816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220826000163 CA Part B Supplier - Clinic/Group Practice 5799169603 Receives reassigned benefits from 3 practitioners
Practice locations: Studio City, CA
O20240103003098 CA DME Supplier - Multi-Specialty - Physician 5799169603 Practice locations: Studio City, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1275280075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12215 VENTURA BLVD STE 208",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042521",
            "telephone_number": "818-505-0816",
            "fax_number": "818-392-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12215 VENTURA BLVD STE 208",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042521",
            "telephone_number": "818-505-0816",
            "fax_number": "818-392-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN RELEASE CENTER A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "KANJI",
        "authorized_official_first_name": "SAVITA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "805-890-8001"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Studio City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.