NPIMap

Organization Active NPI

Sussex Pain Relief Center LLC

  • Pain Medicine Physician
  • Georgetown, DE
National Provider Identifier
1578886180
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
SUSSEX PAIN RELIEF CENTER LLC
Practice address
18229 Dupont Blvd
Georgetown, DE 19947
Phone
(302) 519-1616
Fax
(302) 253-8028
NPI assigned
Mar 10, 2010
Last updated
Oct 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
Dr. Manonmani Antony, MDNPI 1205800125
Title
Owner
Phone
(302) 519-0100

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X DE
Physical Medicine & Rehabilitation Physician 208100000X DE
Pain Medicine Physician 208VP0000X DE Primary
Interventional Pain Medicine Physician 208VP0014X DE

Addresses

Primary practice location

18229 Dupont Blvd
Georgetown, DE 19947

Mailing address

18229 Dupont Blvd
Georgetown, DE 19947-3127
Phone (302) 514-7246

Other identifiers 1

IdentifierTypeStateIssuer
1578886180MedicaidDE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100804000421 DE Part B Supplier - Clinic/Group Practice 8325171887 Receives reassigned benefits from 7 practitioners
Practice locations: Seaford, DE; Rehoboth Beach, DE; Lewes, DE; Georgetown, DE

National Provider Directory

National Provider Directory

Locations

401 Health Services Dr
Seaford Spec Surg
Seaford, DE 19973
Phone (302) 519-1616

Practitioners & affiliated clinicians

Practitioners 10

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": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1578886180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18229 DUPONT BLVD",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199473127",
            "telephone_number": "302-514-7246",
            "fax_number": "302-253-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18229 DUPONT BLVD",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "19947",
            "telephone_number": "302-519-1616",
            "fax_number": "302-253-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSSEX PAIN RELIEF CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "ANTONY",
        "authorized_official_first_name": "MANONMANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-519-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DE",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DE",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "DE",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "DE",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578886180",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.