Organization Active NPI

American Pain & Spine Center, P.C.

  • Interventional Pain Medicine Physician
  • Dearborn, MI
National Provider Identifier
1487972766
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
4301085721 Issued in MI
Legal business name
AMERICAN PAIN & SPINE CENTER, P.C.
Practice address
3845 Monroe St
Dearborn, MI 48124-4607
Phone
(313) 586-4030
Fax
(313) 586-4031
NPI assigned
May 11, 2010
Last updated
Aug 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Authorized official

Name
Dr. Walid Aref Osta, MDNPI 1184832362
Title
Provider
Phone
(313) 586-4030

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 4301085721 MI Primary

Addresses

Primary practice location

3845 Monroe St
Dearborn, MI 48124-4607

Mailing address

3845 Monroe St
Dearborn, MI 48124-4607
Phone (313) 586-4030

Other identifiers 1

IdentifierTypeStateIssuer
1487972766MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100831000024 MI Part B Supplier - Clinic/Group Practice 9436273273 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI

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
23D2099954American Pain & Spine Center, PC3845 Monroe Street, Dearborn, MI 48124Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory

Locations

8534 N Canton Center Rd
Canton, MI 48187
Phone (734) 446-5958

1711 Monroe St
Ofc
Dearborn, MI 48124
Phone (313) 359-9361

3845 Monroe St
Dearborn, MI 48124
Phone (313) 586-4030

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": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1487972766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244607",
            "telephone_number": "313-586-4030",
            "fax_number": "313-586-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244607",
            "telephone_number": "313-586-4030",
            "fax_number": "313-586-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN PAIN & SPINE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "OSTA",
        "authorized_official_first_name": "WALID",
        "authorized_official_middle_name": "AREF",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "313-586-4030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301085721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487972766",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.