NPIMap

Organization Active NPI

Momenta Pain Care, LLC

  • Pain Medicine Physician
  • Omaha, NE
National Provider Identifier
1417474602
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
MOMENTA PAIN CARE, LLC
Practice address
1805 N 145TH St
Omaha, NE 68154
Phone
(402) 991-6559
Fax
(402) 991-3552
NPI assigned
Aug 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Mrs. Shelly Ross
Title
Billing Manager
Phone
(531) 283-5138

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X

Addresses

Primary practice location

1805 N 145TH St
Omaha, NE 68154

Mailing address

1805 N 145TH St
Omaha, NE 68154-1179
Phone (402) 991-6559

Other names 1

  • MOMENTA PAIN BILLING, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180122001746 NE Part B Supplier - Clinic/Group Practice 3779842604 Receives reassigned benefits from 3 practitioners
Practice locations: Omaha, NE
O20190208001164 NE DME Supplier - Physician - Interventional Pain Management 3779842604 Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1503878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1417474602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N 145TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681541179",
            "telephone_number": "402-991-6559",
            "fax_number": "402-991-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N 145TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-991-6559",
            "fax_number": "402-991-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTA PAIN CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-28",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "531-283-5138",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOMENTA PAIN BILLING, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.