Organization Active NPI

Pain and Rehabilitation Physicians. P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Lathrup Village, MI
National Provider Identifier
1356536064
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
4301062397 Issued in MI
Legal business name
PAIN AND REHABILITATION PHYSICIANS. P.C.
Practice address
26333 Southfield Rd
Lathrup Village, MI 48076-4574
Phone
(248) 331-1900
NPI assigned
Sep 6, 2007
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
Dr. Abiola Dianne Obayan, MD
Title
Ceo/Medical Director
Phone
(248) 331-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X 4301062397 MI Primary

Addresses

Primary practice location

26333 Southfield Rd
Lathrup Village, MI 48076-4574

Mailing address

26333 Southfield Rd
Lathrup Village, MI 48076-4574
Phone (248) 331-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040825001423 MI Part B Supplier - Clinic/Group Practice 7113991936 Receives reassigned benefits from 3 practitioners
Practice locations: Lathrup Village, MI
O20170712003235 MI DME Supplier - Physician - Physical and RehabilitationDME Supplier - Physician - Interventional Pain Management 7113991936 Practice locations: Lathrup Village, MI

National Provider Directory

National Provider Directory

Locations

7800 W Outer Dr
Ste 20
Detroit, MI 48235

7800 W Outer Dr
Ste 103
Detroit, MI 48235
Phone (313) 387-1900

7800 W Outer Dr
Ste 203
Detroit, MI 48235
Phone (313) 259-1574

26333 Southfield Rd
Lathrup Village, MI 48076
Phone (248) 331-1900

15565 Northland Dr E
Ste 204E
Southfield, MI 48075
Phone (248) 569-6655

Practitioners & affiliated clinicians

Practitioners 8

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356536064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26333 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764574",
            "telephone_number": "248-331-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26333 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764574",
            "telephone_number": "248-331-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND REHABILITATION PHYSICIANS. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OBAYAN",
        "authorized_official_first_name": "ABIOLA",
        "authorized_official_middle_name": "DIANNE",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-331-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "4301062397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lathrup Village, MI

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.