NPIMap

Organization Active NPI

Grand Island Pain Relief Center PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Grand Island, NE
National Provider Identifier
1346709383
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
GRAND ISLAND PAIN RELIEF CENTER PC
Practice address
403 Lexington Cir
Grand Island, NE 68803-9728
Phone
(308) 675-3222
Fax
(308) 675-3234
NPI assigned
Mar 19, 2019
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Pravardhan Rajashekar Birthi, MDNPI 1013161082
Title
Owner/President
Phone
(308) 675-3222

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
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X Primary
Interventional Pain Medicine Physician 208VP0014X

Addresses

Primary practice location

403 Lexington Cir
Grand Island, NE 68803-9728

Mailing address

403 Lexington Cir
Grand Island, NE 68803-9728
Phone (308) 675-3222

Other practice location 1

726 Eastside Blvd
Hastings, NE 68901-4530
Phone (402) 834-3368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190708002731 NE Part B Supplier - Clinic/Group Practice 7416282868 Receives reassigned benefits from 6 practitioners
Practice locations: Ord, NE; Kearney, NE; Hastings, NE; Grand Island, NE

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
28D2168397Grand Island Pain Relief Center PC403 Lexington Circle, Grand Island, NE 68803Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19476/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 10

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": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1346709383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "308-675-3222",
            "fax_number": "308-675-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LEXINGTON CIR",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688039728",
            "telephone_number": "308-675-3222",
            "fax_number": "308-675-3234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "726 Eastside Blvd",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689014530",
            "country_code": "US",
            "telephone_number": "402-834-3368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRAND ISLAND PAIN RELIEF CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "BIRTHI",
        "authorized_official_first_name": "PRAVARDHAN",
        "authorized_official_middle_name": "RAJASHEKAR",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "308-675-3222",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

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