NPIMap

Organization Active NPI

Bay Area Pain Medical Associates

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Sausalito, CA
National Provider Identifier
1326170374
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P2900X
License
C38406 Issued in CA
Legal business name
BAY AREA PAIN MEDICAL ASSOCIATES
Practice address
3 Harbor Dr
Suite 115
Sausalito, CA 94965-1454
Phone
(415) 380-0480
NPI assigned
Mar 12, 2007
Last updated
Apr 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Diane Keaney, RN, BSNNPI 1225277791
Title
Practice Manager
Phone
(415) 380-0480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11549 CA
Clinical Nurse Specialist 364S00000X 370895 CA
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X C39226 CA
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X C38406 CA Primary

Addresses

Primary practice location

3 Harbor Dr
Suite 115
Sausalito, CA 94965-1454

Mailing address

3 Harbor Dr
Suite 115
Sausalito, CA 94965-1454
Phone (415) 380-0480

National Provider Directory

National Provider Directory

Locations

311 Miller Ave
Ste B
Mill Valley, CA 94941
Phone (415) 380-0480

1050 Northgate Dr
Ste 410
San Rafael, CA 94903
Phone (415) 380-0480

3 Harbor Dr
Ste 115
Sausalito, CA 94965
Phone (415) 380-0480

3 Harbor Dr
Ste 303
Sausalito, CA 94965
Phone (415) 380-0480

Practitioners & affiliated clinicians

Practitioners 5

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1326170374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HARBOR DR",
            "address_2": "SUITE 115",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651454",
            "telephone_number": "415-380-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HARBOR DR",
            "address_2": "SUITE 115",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651454",
            "telephone_number": "415-380-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA PAIN MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "KEANEY",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "415-380-0480",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "11549",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "370895",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "C39226",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "C38406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.