NPIMap

Organization Active NPI

SE Pain Management, LTD

  • Specialist
  • Horsham, PA
National Provider Identifier
1396747531
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SE PAIN MANAGEMENT, LTD
Practice address
508 Prudential Rd Ste 500
Horsham, PA 19044-2309
Phone
(215) 277-5888
Fax
(215) 884-1066
NPI assigned
Jun 1, 2005
Last updated
May 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Authorized official

Name
Renee Passalacqua
Title
Practice Administrator
Phone
(855) 235-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

508 Prudential Rd Ste 500
Horsham, PA 19044-2309

Mailing address

508 Prudential Rd Ste 500
Horsham, PA 19044-2368
Phone (215) 277-5888

Other identifiers 1

IdentifierTypeStateIssuer
1673069MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000021 PA Part B Supplier - Clinic/Group Practice 9830091537 Receives reassigned benefits from 18 practitioners
Practice locations: Horsham, PA; Willow Grove, PA; Levittown, PA; Langhorne, PA; Huntingdon Valley, PA; Chalfont, PA; Abington, PA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

317 W Germantown Pike
Ste 103
East Norriton, PA 19403

508 Prudential Rd
Ste 500
Horsham, PA 19044
Phone (215) 277-5888

325 W Germantown Pike
Ste 205
Norristown, PA 19403

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1396747531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PRUDENTIAL RD STE 500",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442368",
            "telephone_number": "215-277-5888",
            "fax_number": "215-884-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 PRUDENTIAL RD STE 500",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442309",
            "telephone_number": "215-277-5888",
            "fax_number": "215-884-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SE PAIN MANAGEMENT, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "PASSALACQUA",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "855-235-7246"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1673069",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.