NPIMap

Organization Active NPI

Oklahoma Pain Physicians PC

  • Interventional Pain Medicine Physician
  • Purcell, OK
National Provider Identifier
1649518564
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
27480 Issued in OK
Legal business name
OKLAHOMA PAIN PHYSICIANS PC
Practice address
1500 N Green Ave
#106
Purcell, OK 73080-1642
Phone
(405) 657-4800
Fax
(405) 396-3364
NPI assigned
Jan 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Authorized official

Name
Rafael Justiz III, M.D.NPI 1043226384
Title
Owner
Phone
(405) 657-4800

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
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 27480 OK Primary

Addresses

Primary practice location

1500 N Green Ave
#106
Purcell, OK 73080-1642

Mailing address

PO Box 268953
Oklahoma City, OK 73126-8953
Phone (405) 657-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131106001426 OK Part B Supplier - Clinic/Group Practice 1658506290 Receives reassigned benefits from 7 practitioners
Practice locations: Norman, OK; Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

1215 Crossroads Blvd
Ste 100
Norman, OK 73072
Phone (405) 310-2715

6001 NW 139th St
#102
Oklahoma City, OK 73142
Phone (405) 606-8950

1500 N Green Ave
#106
Purcell, OK 73080
Phone (405) 657-4800

Practitioners & affiliated clinicians

Practitioners 9

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": "1359331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1649518564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268953",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268953",
            "telephone_number": "405-657-4800",
            "fax_number": "405-396-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N GREEN AVE",
            "address_2": "#106",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730801642",
            "telephone_number": "405-657-4800",
            "fax_number": "405-396-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA PAIN PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-28",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "JUSTIZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-657-4800",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "27480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Purcell, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.