Individual provider Active NPI

Sasa Periskic, M.D.

  • Interventional Pain Medicine Physician
  • Melrose, MA
National Provider Identifier
1447253976
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
203186 Issued in MA
Practice address
50 Rowe St Ste 100
Melrose, MA 02176-3231
Phone
(781) 662-7246
NPI assigned
May 30, 2005
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 203186 MA
Interventional Pain Medicine Physician 208VP0014X 203186 MA Primary

Addresses

Primary practice location

50 Rowe St Ste 100
Melrose, MA 02176-3231

Mailing address

50 Rowe St Ste 100
Melrose, MA 02176-3231
Phone (781) 662-7246

Other practice location 1

50 Tremont St Ste 103
Boston Pain Specialist, P.C.
Melrose, MA 02176-2721
Phone (781) 662-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000781 MA Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 1759353147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Tremont St
Suite 103
Melrose, MA 02176-2721
Phone (781) 662-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Pain Specialist, PC Pain Medicine CurrentSince Aug 1, 2003 Accepting new patients
Marion Surgical Associates, Inc Past Accepting new patients
Hallmark Health System Inc Past Accepting new patients
New England Pain Associates, P.C. Pain Medicine Past Accepting new patients
Anesthetics of Massachusetts, PC Pain Medicine Past Accepting new patients

Locations

50 Rowe St
Ste 100
Melrose, MA 02176
Phone (781) 662-7246

50 Tremont St
Ste 103
Melrose, MA 02176
Phone (781) 662-7246

Interoperability endpoints

  • Direct secure messaging: speriskic28861@tuftsmedicine.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1447253976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROWE ST STE 100",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763231",
            "telephone_number": "781-662-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROWE ST STE 100",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763231",
            "telephone_number": "781-662-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Tremont St Ste 103",
            "address_2": "Boston Pain Specialist, P.C.",
            "address_purpose": "LOCATION",
            "city": "Melrose",
            "state": "MA",
            "postal_code": "021762721",
            "country_code": "US",
            "telephone_number": "781-662-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERISKIC",
        "first_name": "SASA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-30",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MA",
            "license": "203186",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MA",
            "license": "203186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.