Organization Active NPI

Nuvation Pain Group

  • Interventional Pain Medicine Physician
  • Buena Park, CA
National Provider Identifier
1346616695
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
NUVATION PAIN GROUP
Practice address
5832 Beach Blvd Unit 209
Buena Park, CA 90621-5501
Phone
(714) 676-5541
Fax
(714) 676-5542
NPI assigned
Aug 20, 2015
Last updated
Aug 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Dr. Phillip H Lim, DO, MPHNPI 1023227154
Title
Ceo
Phone
(714) 676-5541

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
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

5832 Beach Blvd Unit 209
Buena Park, CA 90621-5501

Mailing address

5832 Beach Blvd Unit 209
Buena Park, CA 90621-5501
Phone (714) 676-5541

Other practice location 1

505 S Virgil Ave Ste 206
Los Angeles, CA 90020-1443
Phone (213) 622-0021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151222002466 CA Part B Supplier - Clinic/Group Practice 1254632938 Receives reassigned benefits from 4 practitioners
Practice locations: Buena Park, CA; Los Angeles, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2164821Nuvation Pain Group505 S Virgil, Suite 206, Los Angeles, CA 90020Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1346616695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5832 BEACH BLVD UNIT 209",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906215501",
            "telephone_number": "714-676-5541",
            "fax_number": "714-676-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 BEACH BLVD UNIT 209",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906215501",
            "telephone_number": "714-676-5541",
            "fax_number": "714-676-5542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Virgil Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900201443",
            "country_code": "US",
            "telephone_number": "213-622-0021",
            "fax_number": "714-676-5542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NUVATION PAIN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-676-5541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, MPH"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.