Pain Management & Surgery Center of Southern Indiana

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

61100223B Issued in IN

Legal business name

PAIN MANAGEMENT & SURGERY CENTER OF SOUTHERN INDIANA

Practice address

2920 McIntyre Dr
Suite 150
Bloomington, IN 47403-4221

Phone

(812) 333-7246

Fax

(812) 333-4471

NPI assigned

Sep 15, 2005

Organization subpart

No

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

Authorized official

Name

Kamal Kumar Tiwari, MDNPI 1578558789

Title

President

Phone

(812) 824-5688

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamal Kumar Tiwari, M.D.

  • Interventional Pain Medicine Physician
  • Bloomington, IN
  • NPI 1578558789
  NPD (past) Authorized official
• Yunus M. Shah, MD

  • Pain Medicine (Anesthesiology) Physician
  • Corydon, IN
  • NPI 1376595892
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538154604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5635",
            "address_2": "ATTN MARIA MITCHELL",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474075635",
            "telephone_number": "812-824-5688",
            "fax_number": "812-824-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 MCINTYRE DR",
            "address_2": "SUITE 150",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034221",
            "telephone_number": "812-333-7246",
            "fax_number": "812-333-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT & SURGERY CENTER OF SOUTHERN INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIWARI",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-824-5688",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "61100223B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000098134",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla Jo Pace, PTA
• Christie Leigh Pace, OTR
• Caesar Pacifici, PH.D.
• Stephanie Page, RBT
• Pain and Aging Management LLC
• Pain Management Center of Southern Indiana, Inc.
• Seth Painter, D.C.
• Taylor Painter
• Angela Palacios
• Mikayla Renee Palmerone, RBT

• Ambulatory Surgical Clinic/Center in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.