Organization Active NPI

Pain MDS Inc

  • Ambulatory Surgical Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1649407180
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PAIN MDS INC
Practice address
2525 W Carefree Hwy Ste 134
Phoenix, AZ 85085
Phone
(623) 580-4357
Fax
(623) 580-5249
NPI assigned
Jun 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Authorized official

Name
Paul Anthony Pannozzo, MDNPI 1497792097
Title
Medical Director
Phone
(623) 776-8686

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X AZ
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X AZ
Ambulatory Surgical Clinic/Center 261QA1903X AZ Primary

Addresses

Primary practice location

2525 W Carefree Hwy Ste 134
Phoenix, AZ 85085

Mailing address

2525 W Carefree Hwy
Suite 134, Building 5
Phoenix, AZ 85085-6093
Phone (623) 580-4357

Other identifiers 1

IdentifierTypeStateIssuer
670929MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100415000986 AZ Part B Supplier - Ambulatory Surgical Center 7416084827 Practice locations: Phoenix, AZ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pain MDS IncCCN 03C0001327
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536192000000",
    "number": "1649407180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W CAREFREE HWY",
            "address_2": "SUITE 134, BUILDING 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856093",
            "telephone_number": "623-580-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W CAREFREE HWY STE 134",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85085",
            "telephone_number": "623-580-4357",
            "fax_number": "623-580-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2018-09-06",
        "status": "A",
        "authorized_official_last_name": "PANNOZZO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "623-776-8686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "670929",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.