NPIMap

Organization Active NPI

Pain Management Associates

  • Pain Medicine (Anesthesiology) Physician
  • Bowie, MD
National Provider Identifier
1487837886
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
D0059481 Issued in MD
Legal business name
PAIN MANAGEMENT ASSOCIATES
Practice address
4000 Mitchellville Rd. Suite B 116
Bowie, MD 20716
Phone
(301) 464-5575
Fax
(301) 805-9791
NPI assigned
Dec 10, 2007
Last updated
Feb 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Authorized official

Name
Dr. Haddis T Hagos, M.D.
Title
Prsident
Phone
(301) 464-5575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X D0059481 MD Primary

Addresses

Primary practice location

4000 Mitchellville Rd. Suite B 116
Bowie, MD 20716

Mailing address

3247 Eleanors Garden Way
Woodbine, MD 21797-7508
Phone (301) 704-0681

Other identifiers 6

IdentifierTypeStateIssuer
0455830MedicaidDC
HMO 3214770OtherAETNA US HEALTHCARE
G627/0001OtherBC/BS/CHOICE/FED
00B889P38OtherMDPROVIDER PIN NUMBER
NON HMO 4240271OtherAETNA US HEALTHCARE
310473OtherMAMSI/ALLIANCE

National Provider Directory

National Provider Directory
Tax ID family
Pain Management Assoc LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1487837886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3247 ELEANORS GARDEN WAY",
            "city": "WOODBINE",
            "state": "MD",
            "postal_code": "217977508",
            "telephone_number": "301-704-0681",
            "fax_number": "301-805-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD. SUITE B 116",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20716",
            "telephone_number": "301-464-5575",
            "fax_number": "301-805-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "HAGOS",
        "authorized_official_first_name": "HADDIS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRSIDENT",
        "authorized_official_telephone_number": "301-464-5575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D0059481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0455830",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "HMO 3214770",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS/CHOICE/FED",
            "identifier": "G627/0001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER PIN NUMBER",
            "identifier": "00B889P38",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "NON HMO 4240271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/ALLIANCE",
            "identifier": "310473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.