1155 Neuro Pain Services, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

203454 Issued in NY

Legal business name

1155 NEURO PAIN SERVICES, PC

Practice address

16408 65TH Ave
Fresh Meadows, NY 11365-1803

Phone

(718) 460-1111

Fax

(718) 460-5111

NPI assigned

Jan 8, 2007

Last updated

Mar 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vikas Varma

Title

MBBS

Phone

(718) 460-1111

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Anil Prabhakaran Pisharoty, MD

  • Anesthesiology Physician
  • Rego Park, NY
  • NPI 1689782443
  NPD (past)
• Vikas Varma, MD

  • Specialist
  • Fresh Meadows, NY
  • NPI 1306870720
  NPD (past)
• Vikas V. Varma, MD

  • Orthopaedic Surgery Physician
  • New York, NY
  • NPI 1386684314
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1306994959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 NORTHERN BLVD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303040",
            "telephone_number": "718-460-1111",
            "fax_number": "718-460-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16408 65TH AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651803",
            "telephone_number": "718-460-1111",
            "fax_number": "718-460-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1155 NEURO PAIN SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "VARMA",
        "authorized_official_first_name": "VIKAS",
        "authorized_official_title_or_position": "MBBS",
        "authorized_official_telephone_number": "718-460-1111"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "203454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE MEDICARE",
            "identifier": "W38531",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI MEDICARE",
            "identifier": "08047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 189-04 Facility Inc
• A & R Billing Services LLC
• A. Klein M.D. Consulting, P.C.
• A.M. Early Start Inc
• A&S Rehabilitation PT, P.C.

• Specialist in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.