Specialty Pain Management Services

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

SPECIALTY PAIN MANAGEMENT SERVICES

Practice address

8008 Nightwind CT
Elkridge, MD 21075-6463

Phone

(410) 404-6071

NPI assigned

Jun 18, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Lydia Bongiorni, OTR/L

Title

Occupational Therapist

Phone

(443) 472-2449

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

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

• Lydia Nemirovsky, MS, OTR/L

  • Occupational Therapist
  • Elkridge, MD
  • NPI 1053798140
  Medicare reassignment

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1316516909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 NIGHTWIND CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756463",
            "telephone_number": "410-404-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 NIGHTWIND CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756463",
            "telephone_number": "410-404-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PAIN MANAGEMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "BONGIORNI",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "443-472-2449",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Sobon, RPH
• Soon Ja Kim MD PA
• Laura Marder Sorkin, CRNP
• Rachel Carolyn Souza, M.A., BCBA
• Mary Spangler, CRNP
• Speech Prints
• Barbara A. Spencer, CRNP
• Carolyn Spencer
• Susan A Spencer, RN
• Andrew K Stanton, MSW, LCSW-C

• Rehabilitation Clinic/Center in Elkridge, MD
• Providers in Elkridge, MD by specialty
• Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.