Organization Active NPI

Medical Pain Management of New York PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Brooklyn, NY
National Provider Identifier
1295561504
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MEDICAL PAIN MANAGEMENT OF NEW YORK PLLC
Practice address
1911 Avenue L
Brooklyn, NY 11230-5002
Phone
(718) 679-6486
NPI assigned
Sep 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Isaiah FlorenceNPI 1114906377
Title
MD
Phone
(718) 679-6486

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

1911 Avenue L
Brooklyn, NY 11230-5002

Mailing address

1911 Avenue L
Brooklyn, NY 11230-5002
Phone (718) 679-6486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250502002584 NY Part B Supplier - Clinic/Group Practice 9739606757 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

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": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1295561504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305002",
            "telephone_number": "718-679-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305002",
            "telephone_number": "718-679-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PAIN MANAGEMENT OF NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FLORENCE",
        "authorized_official_first_name": "ISAIAH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-679-6486"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.