Organization Active NPI

Koenigsberg & Associates Pain Management LLC

  • Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1326033994
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
KOENIGSBERG & ASSOCIATES PAIN MANAGEMENT LLC
Practice address
2222 S Broad St
Philadelphia, PA 19145-3948
Phone
(215) 467-7212
Fax
(215) 467-7216
NPI assigned
Sep 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Don A Koenigsberg, DONPI 1356338792
Title
President
Phone
(215) 467-7212

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X PA Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X PA

Addresses

Primary practice location

2222 S Broad St
Philadelphia, PA 19145-3948

Mailing address

2222 S Broad St
Philadelphia, PA 19145-3948
Phone (215) 467-7212

Other identifiers 1

IdentifierTypeStateIssuer
1010771660001MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040812000518 PA Part B Supplier - Clinic/Group Practice 1456323062 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

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": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1326033994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453948",
            "telephone_number": "215-467-7212",
            "fax_number": "215-467-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453948",
            "telephone_number": "215-467-7212",
            "fax_number": "215-467-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOENIGSBERG & ASSOCIATES PAIN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KOENIGSBERG",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-467-7212",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010771660001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.