Pain Care Providers a Professional Medical Corporation

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

A81189 Issued in CA

Legal business name

PAIN CARE PROVIDERS A PROFESSIONAL MEDICAL CORPORATION

Practice address

113 Waterworks Way
Suite 345
Irvine, CA 92618-3167

Phone

(949) 872-2400

Fax

(949) 872-2401

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Amir Bahram Rafizad, M. D.NPI 1073559241

Title

President

Phone

(949) 872-2400

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Pain Care Providers a Professional Medical Corporation

  • Ambulatory Surgical Clinic/Center
  • Irvine, CA
  • NPI 1861760670

  4789646480

  Same PAC ID

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

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

• Amir B Rafizad, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Irvine, CA
  • NPI 1073559241
  Medicare reassignment Authorized official
• Reza Mahrou, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Irvine, CA
  • NPI 1255376810
  Medicare reassignment

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482192000000",
    "number": "1578627022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54788",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926194788",
            "telephone_number": "949-872-2400",
            "fax_number": "949-872-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY",
            "address_2": "SUITE 345",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183167",
            "telephone_number": "949-872-2400",
            "fax_number": "949-872-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE PROVIDERS A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-12-20",
        "status": "A",
        "authorized_official_last_name": "RAFIZAD",
        "authorized_official_first_name": "AMIR",
        "authorized_official_middle_name": "BAHRAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-872-2400",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A81189",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A81189",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A81189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC3554",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W18108",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Hunter Paduano
• Victor Paez
• Katherine Anne Pagtama, BS, RBT
• Majid Pahlevan Hosseini, PT PHYSICAL THERAPIS
• Brian Joongkevn Paik, M.D
• Pain Care Providers a Professional Medical Corporation
• Pain Dynamics, LLC
• Pain Free Essentials
• Pain Management Center of Irvine, Inc.
• Pain Relief Acupuncture

• Interventional Pain Medicine Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.