Advanced Pain Care LLC
Organization Active NPI Specialist · Maplewood, NJ
NPI 1639487259 · NPPES record last updated Dec 5, 2018
Key facts
- NPI
- 1639487259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 25MA08392000 (NJ)
- Legal business name
- ADVANCED PAIN CARE LLC
- Practice address
- 2040 Millburn Ave Ste 104
Maplewood, NJ 07040-3716 - Phone
- (908) 242-3688
- Fax
- (908) 242-3902
- NPI assigned
- Sep 16, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Ningning He, MD
- Title
- Owner
- Phone
- (908) 723-6901
Other NPIs on the same Medicare enrollment 1
Subparts reporting this organization as parent 2
Member organizations 1
Practitioners 6
-
Ningning He, MD
-
Jerry Kong, P.A.
-
Ashish Patel, PA-C
-
David Nathan Feldman, M.D.
-
Glorimar Weaver, PA-C
-
Joshua Persaud, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110127000292 | NJ | Part B Supplier - Clinic/Group Practice | 7315126018 |
Receives reassigned benefits from 6 practitioners 1 other NPI on this enrollment Practice locations: Maplewood, NJ |
National Provider Directory
Locations
2040 Millburn Ave
Ste 104
Maplewood, NJ 07040
Phone (908) 242-3688
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 25MA08392000 | NJ | Yes |
Addresses
Primary practice location
2040 Millburn Ave Ste 104
Maplewood, NJ 07040-3716
Mailing address
2040 Millburn Ave Ste 201
Maplewood, NJ 07040-3716
Phone (908) 723-6901
Other providers in Maplewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.