NPIMap

Organization Active NPI

Spine, Orthopedic and Pain Center PC

  • Clinic/Center
  • Bismarck, ND
National Provider Identifier
1639148463
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SPINE, ORTHOPEDIC AND PAIN CENTER PC
Practice address
121 W Century Ave
Bismarck, ND 58503-1402
Phone
(701) 751-7750
Fax
(701) 751-7734
NPI assigned
Mar 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Authorized official

Name
Dr. Michael Paul Martire, MDNPI 1013999572
Title
Medical Director
Phone
(701) 751-7750

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

121 W Century Ave
Bismarck, ND 58503-1402

Mailing address

121 W Century Ave
Bismarck, ND 58503-1402
Phone (701) 751-7750

Other identifiers 2

IdentifierTypeStateIssuer
01060/002OtherNDBCBS GROUP NUMBER
13043MedicaidND

Other names 1

  • Spine & Pain Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419001432 ND Part B Supplier - Clinic/Group Practice 9436144391 Receives reassigned benefits from 3 practitioners
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Locations

121 W Century Ave
Bismarck, ND 58503
Phone (701) 530-8500

Practitioners & affiliated clinicians

Practitioners 12

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": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1639148463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W CENTURY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031402",
            "telephone_number": "701-751-7750",
            "fax_number": "701-751-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W CENTURY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031402",
            "telephone_number": "701-751-7750",
            "fax_number": "701-751-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE, ORTHOPEDIC AND PAIN CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "MARTIRE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "701-751-7750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "01060/002",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13043",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine & Pain Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spine & Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

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