Organization Active NPI

Pioneer Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Port St Lucie, FL
National Provider Identifier
1437603404
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PIONEER PAIN MANAGEMENT
Practice address
266 NW Peacock Blvd Ste 205
Port St Lucie, FL 34986-2271
Phone
(772) 446-4883
NPI assigned
Aug 8, 2016
Last updated
Nov 3, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
PIONEER PAIN MANAGEMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Authorized official

Name
Dr. Antonio Poto Jr., D.O.NPI 1982875621
Title
Owner/ Authorized Official
Phone
(772) 446-4883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

266 NW Peacock Blvd Ste 205
Port St Lucie, FL 34986-2271

Mailing address

266 NW Peacock Blvd Ste 205
Port St Lucie, FL 34986-2271
Phone (772) 446-4883

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2134321Pioneer Pain Management, Inc266 NW Peacock Blvd Ste 205, Port Saint Lucie, FL 34986Certificate of waiverJul 30, 2027

National Provider Directory

National Provider Directory
Part of
Pioneer Pain Management

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1437603404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 NW PEACOCK BLVD STE 205",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862271",
            "telephone_number": "772-446-4883",
            "fax_number": "772-446-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 NW PEACOCK BLVD STE 205",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862271",
            "telephone_number": "772-446-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER PAIN MANAGEMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIONEER PAIN MANAGEMENT",
        "enumeration_date": "2016-08-08",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "POTO",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER/ AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "772-446-4883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.