Bayonne Pain Management Center, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

BAYONNE PAIN MANAGEMENT CENTER, LLC

Practice address

631 Broadway
Bayonne, NJ 07002-3846

Phone

(201) 471-7246

Fax

(201) 471-7242

NPI assigned

Sep 17, 2018

Last updated

Sep 17, 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

Mamdouh S Hanna, MDNPI 1073517462

Title

MD / Owner

Phone

(201) 303-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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.

• Mamdouh S Hanna, M.D.

  • Specialist
  • Bayonne, NJ
  • NPI 1073517462
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1437633492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023846",
            "telephone_number": "201-471-7246",
            "fax_number": "201-471-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023846",
            "telephone_number": "201-471-7246",
            "fax_number": "201-471-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYONNE PAIN MANAGEMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-17",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "MAMDOUH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MD / OWNER",
        "authorized_official_telephone_number": "201-303-7700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bayonne Hospital Physicians
• Bayonne Imaging Associates, LLC.
• Bayonne Medical Center
• Bayonne Medical Plaza, LLC (Integrated Medical Center)
• Bayonne Ortho Fitting LLC (Bayonne Medical supply)
• Bayonne Pediatric Practice
• Bayonne Pediatric Therapy Center LLC
• Bayonne Pharmacy Group LLC (Broadway Care Pharmacy)
• Bayonne Pharmacy Inc
• Bayonne Pharmacy Inc (Jerrys Drug & Surgical Supply)

• Interventional Pain Medicine Physician in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Interventional Pain Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.