NPIMap

Organization Active NPI

Commonwealth Pain Associates PLLC

  • Durable Medical Equipment & Medical Supplies
  • Evansville, IN
National Provider Identifier
1619336435
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
COMMONWEALTH PAIN ASSOCIATES PLLC
Practice address
700 Kimber Lane
Evansville, IN 47715
Phone
(812) 476-7111
Fax
(812) 476-7117
NPI assigned
Feb 22, 2016
Last updated
Jun 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Jason Lewis, MDNPI 1720127913
Title
Owner
Phone
(502) 855-7200

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

700 Kimber Lane
Evansville, IN 47715

Mailing address

PO Box 21890
Belfast, ME 04915-4115
Phone (502) 907-0356

Other identifiers 2

IdentifierTypeStateIssuer
IN2373OtherINPTAN
201287400BMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171020002435 IN DME Supplier - Physician - Interventional Pain Management 0941441919 Practice locations: Evansville, IN

Other NPIs with the same Medicare PAC ID 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Pain Spine38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Practitioners & affiliated clinicians

Practitioners 1

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": "1456099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1619336435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21890",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154115",
            "telephone_number": "502-907-0356",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 KIMBER LANE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47715",
            "telephone_number": "812-476-7111",
            "fax_number": "812-476-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH PAIN ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-22",
        "last_updated": "2022-06-03",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-855-7200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IN2373",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201287400B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.