Organization Active NPI

Center for Pain & Rehabilitation Medicine

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • San Jose, CA
National Provider Identifier
1477573285
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
CENTER FOR PAIN & REHABILITATION MEDICINE
Practice address
3097 Moorpark Ave Ste 200
San Jose, CA 95128-2543
Phone
(408) 244-7246
Fax
(408) 244-7248
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Dr. Michael M Jadali, DONPI 1891723375
Title
Medical Director
Phone
(408) 244-7246

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081N0008X
Brain Injury Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P0301X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X
Medical Specialty Clinic/Center 261QM2500X

Addresses

Primary practice location

3097 Moorpark Ave Ste 200
San Jose, CA 95128-2543

Mailing address

3097 Moorpark Ave Ste 200
San Jose, CA 95128-2543
Phone (408) 244-7246

Other names 1

  • CPRM Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070302000324 CA Part B Supplier - Clinic/Group Practice 7214935055 Receives reassigned benefits from 3 practitioners
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

221 Almendra Ave
Los Gatos, CA 95030
Phone (408) 354-2300

3097 Moorpark Ave
Ste 200
San Jose, CA 95128
Phone (408) 244-7246

Practitioners & affiliated clinicians

Practitioners 4

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1477573285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3097 MOORPARK AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282543",
            "telephone_number": "408-244-7246",
            "fax_number": "408-244-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 MOORPARK AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282543",
            "telephone_number": "408-244-7246",
            "fax_number": "408-244-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PAIN & REHABILITATION MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "JADALI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "408-244-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPRM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.