Complete Pain Management & Rehabilitation LLC
Organization Active NPI Physical Medicine & Rehabilitation Physician · Henderson, NV
NPI 1376795823 · NPPES record last updated Jul 11, 2014
Key facts
- NPI
- 1376795823
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 12082 (NV)
- Legal business name
- COMPLETE PAIN MANAGEMENT & REHABILITATION LLC
- Practice address
- 1358 Paseo Verde Pkwy
Suite #100
Henderson, NV 89012-5724 - Phone
- (702) 982-7100
- Fax
- (702) 982-7102
- NPI assigned
- Oct 15, 2008
- Organization subpart
- No
Authorized official
- Name
- Alexander Imas, M.D.
- Title
- President
- Phone
- (702) 982-7100
Practitioners 4
-
Alexander Imas, MD
-
Krystal Steckel, PA-C
-
Isaac B. Tunnell, P.A.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D1090676 | Dynamic Pain Rehabilitation | Certificate of waiver | Oct 15, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081113000222 | NV | Part B Supplier - Clinic/Group Practice | 0244390730 |
Receives reassigned benefits from 4 practitioners Practice locations: Henderson, NV |
| O20130329000107 | NV | DME Supplier - Physician - Physical and Rehabilitation | 0244390730 | Practice locations: Henderson, NV |
National Provider Directory
Locations
100 Delmar Gardens Dr
Henderson, NV 89074
Phone (702) 361-6111
1358 Paseo Verde Pkwy
Ste 100
Henderson, NV 89012
Phone (702) 982-7100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician |
208100000X | 12082 | NV | Yes |
Addresses
Primary practice location
1358 Paseo Verde Pkwy
Suite #100
Henderson, NV 89012-5724
Mailing address
PO Box 531666
Henderson, NV 89053-1666
Phone (702) 982-7100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6727480001 | Other | NV | PTAN |
Other names
- Dynamic Pain Rehabilitation
Other providers in Henderson, NV
- Complete Care Group Home
- Complete Family Care Center, LLC
- Complete Family Care Medical, PPLC
- Complete Health and Wellness
- Complete Medical Consultants, LLC
- Comprehensive and Interventional Pain Management LLP
- Comprehensive Dental Care
- Comprehensive Hearing Center of Las Vegas
- Comprehensive Medical Center
- Comprehensive Psychological Services LLC
All providers in Henderson, NV · Physical Medicine & Rehabilitation Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.