NPIMap

Organization Active NPI

Painstop Spine Clinic, LLC

  • Interventional Pain Medicine Physician
  • Pascagoula, MS
National Provider Identifier
1558666149
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAINSTOP SPINE CLINIC, LLC
Practice address
3003 Shortcut Rd
Pascagoula, MS 39567-1810
Phone
(228) 273-4096
Fax
(228) 594-1765
NPI assigned
Jan 13, 2011
Last updated
Jan 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Authorized official

Name
Mrs. Stacey M Tsang
Title
General Manager
Phone
(626) 512-6348

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

3003 Shortcut Rd
Pascagoula, MS 39567-1810

Mailing address

PO Box 4594
Biloxi, MS 39535-4594
Phone (228) 273-4096

Other identifiers 3

IdentifierTypeStateIssuer
DT9919OtherMSRAILROAD MEDICARE, GROUP PTAN
30270G0134OtherMSMCR PTAN GROUP
00057070MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address billing@painstopspineclinic.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170829003606 MS DME Supplier - Physician - Interventional Pain Management 9739355124 Practice locations: Pascagoula, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Painstop Spine Clinic 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.

Locations

180B Debuys Rd
Biloxi, MS 39531
Phone (228) 273-4096

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1558666149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4594",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395354594",
            "telephone_number": "228-273-4096",
            "fax_number": "228-594-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 SHORTCUT RD",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395671810",
            "telephone_number": "228-273-4096",
            "fax_number": "228-594-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINSTOP SPINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "TSANG",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "626-512-6348",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE, GROUP PTAN",
            "identifier": "DT9919",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR PTAN GROUP",
            "identifier": "30270G0134",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00057070",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@painstopspineclinic.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "all",
            "address_1": "3003 Shortcut Rd",
            "city": "Pascagoula",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395671810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.