NPIMap

Organization Active NPI

Spine and Pain Medical PLLC

  • Ambulatory Surgical Clinic/Center
  • Scarsdale, NY
National Provider Identifier
1538510466
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
6143 Issued in NY
Legal business name
SPINE AND PAIN MEDICAL PLLC
Practice address
83 Montgomery Ave
Scarsdale, NY 10583-5104
Phone
(914) 681-9089
NPI assigned
Jun 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Mr. Dae Kang
Title
Billing Manager
Phone
(914) 681-9089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 6143 NY Primary

Addresses

Primary practice location

83 Montgomery Ave
Scarsdale, NY 10583-5104

Mailing address

200 S Broadway
Suite 205
Tarrytown, NY 10591-4500
Phone (917) 572-7108

National Provider Directory

National Provider Directory

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": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1538510466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S BROADWAY",
            "address_2": "SUITE 205",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914500",
            "telephone_number": "917-572-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 MONTGOMERY AVE",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835104",
            "telephone_number": "914-681-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND PAIN MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "DAE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "914-681-9089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "6143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.