NPIMap

Organization Active NPI

Wooster Pain and Anesthesia Center LLC

  • Pain Medicine (Anesthesiology) Physician
  • Wooster, OH
National Provider Identifier
1649616947
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
WOOSTER PAIN AND ANESTHESIA CENTER LLC
Practice address
3373 Commerce Pkwy
Suite 3
Wooster, OH 44691-7130
Phone
(330) 284-9119
NPI assigned
May 14, 2013
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Maher J Zackary, MDNPI 1164685053
Title
Authorized Representative
Phone
(330) 284-9119

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
Pain Medicine (Anesthesiology) Physician 207LP2900X Primary

Addresses

Primary practice location

3373 Commerce Pkwy
Suite 3
Wooster, OH 44691-7130

Mailing address

3373 Commerce Pkwy
Suite 3
Wooster, OH 44691-7130
Phone (330) 439-4656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130620000172 OH Part B Supplier - Clinic/Group Practice 1557500782 Receives reassigned benefits from 55 practitioners
Practice locations: Wooster, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2062574Wooster Pain and Anesthesia Center3373 Commerce Pkwy Ste 3, Wooster, OH 44691Certificate of waiverJul 17, 2027

National Provider Directory

National Provider Directory

Locations

3373 Commerce Pkwy
Ste 3
Wooster, OH 44691
Phone (330) 284-9119

Practitioners & affiliated clinicians

Practitioners 56

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.

View all 56

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1649616947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3373 COMMERCE PKWY",
            "address_2": "SUITE 3",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917130",
            "telephone_number": "330-439-4656",
            "fax_number": "888-833-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3373 COMMERCE PKWY",
            "address_2": "SUITE 3",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446917130",
            "telephone_number": "330-284-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOSTER PAIN AND ANESTHESIA CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "ZACKARY",
        "authorized_official_first_name": "MAHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "330-284-9119",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.