NPIMap

Organization Active NPI

Interventional Pain Specialists, PLLC

  • Interventional Pain Medicine Physician
  • Houston, TX
National Provider Identifier
1407358641
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
INTERVENTIONAL PAIN SPECIALISTS, PLLC
Practice address
16840 Buccaneer LN Ste 202
Houston, TX 77058-2563
Phone
(281) 991-2200
Fax
(281) 991-7700
NPI assigned
Mar 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
James M DieterNPI 1114159142
Title
President
Phone
(281) 944-4701

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

16840 Buccaneer LN Ste 202
Houston, TX 77058-2563

Mailing address

5010 Crenshaw Rd Ste 130
Pasadena, TX 77505-4615
Phone (281) 991-2200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190403000362 TX DME Supplier - Physician - AnesthesiologyDME Supplier - Physician - Physical and Rehabilitation 2769634799 Practice locations: Houston, TX

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Interventional Pain Specialists PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

80 Ih 10 N
Ste 101
Beaumont, TX 77702

1021 61st St
Ste 200
Galveston, TX 77551
Phone (409) 740-6800

7111 Medical Center Dr
Ste 111
Texas City, TX 77591
Phone (409) 935-2840

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1520121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1407358641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 CRENSHAW RD STE 130",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775054615",
            "telephone_number": "281-991-2200",
            "fax_number": "281-991-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16840 BUCCANEER LN STE 202",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582563",
            "telephone_number": "281-991-2200",
            "fax_number": "281-991-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-04",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A",
        "authorized_official_last_name": "DIETER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-944-4701"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.