Doctors Pain Center, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

DOCTORS PAIN CENTER, LLC

Practice address

1011 Boardman Canfield Rd
Boardman, OH 44512

Phone

(330) 629-2888

Fax

(330) 259-9625

NPI assigned

May 22, 2006

Last updated

Aug 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Lee Neuendorf, D.O.NPI 1275509275

Title

President/Ceo/Owner

Phone

(330) 629-2888

Specialties & licenses 8

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

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.

• Tracy L Neuendorf, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Youngstown, OH
  • NPI 1275509275
  Medicare reassignment Authorized official
• Dawn Darice Lundy, CNP

  • Family Nurse Practitioner
  • Kent, OH
  • NPI 1821861725
  Medicare reassignment NPD
• Briana Marie Sanford, NP-C

  • Family Nurse Practitioner
  • Boardman, OH
  • NPI 1225408123
  Medicare reassignment NPD
• Heather Marie Schmidt, CNP

  • Family Nurse Practitioner
  • Youngstown, OH
  • NPI 1548998305
  Medicare reassignment NPD
• Kelley Lynne Younkins, NP-C

  • Adult Health Nurse Practitioner
  • Youngstown, OH
  • NPI 1427456433
  Medicare reassignment NPD
• Jason Sindledecker, NP-C

  • Adult Health Nurse Practitioner
  • Youngstown, OH
  • NPI 1023406394
  Medicare reassignment
• Evelyn Oteng-Bediako, MD

  • Pain Medicine (Anesthesiology) Physician
  • Sayre, PA
  • NPI 1790825040
  NPD (past)
• Mark Anthony Quintero, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Miami, FL
  • NPI 1083804579
  NPD (past)
• Melissa A Scales, CRNP

  • Acute Care Nurse Practitioner
  • Farrell, PA
  • NPI 1700531480
  NPD (past)
• Brandon Patrick Staub, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Greenville, PA
  • NPI 1063809317
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1386698215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124226",
            "telephone_number": "330-629-2888",
            "fax_number": "330-629-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-629-2888",
            "fax_number": "330-259-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "NEUENDORF",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT/CEO/OWNER",
        "authorized_official_telephone_number": "330-629-2888",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "111998",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2469154",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2462154",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018803700001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "1954815",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "340892",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie A Diorio
• Shana Dipiero, ST
• Anthony James Direnzo, D.D.S.
• Taylor J Dirienzo
• Trenika Dixon
• Dominic F Conti DO LTD
• Donald a Dechellis DDS Inc
• Kimberly Donaldson Brincko, OTAL
• Derek Doss
• Sherraine D Dothard

• Pain Medicine (Anesthesiology) Physician in Boardman, OH
• Providers in Boardman, OH by specialty
• Pain Medicine (Anesthesiology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.