NPIMap

Organization Active NPI

Commonwealth Pain Associates PLLC

Doing business as Commonwealth Pain And Spine

  • Durable Medical Equipment & Medical Supplies
  • Terre Haute, IN
National Provider Identifier
1659107241
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
COMMONWEALTH PAIN ASSOCIATES PLLC
Doing business as
Commonwealth Pain And Spine
Practice address
3903 S 7TH St Ste 1a
Terre Haute, IN 47802-5710
Phone
(812) 476-7111
Fax
(812) 476-7117
NPI assigned
Sep 10, 2024
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Jason Carnes LewisNPI 1720127913
Title
Owner
Phone
(502) 855-3919

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
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3903 S 7TH St Ste 1a
Terre Haute, IN 47802-5710

Mailing address

PO Box 21890
Belfast, ME 04915-4115
Phone (502) 907-0356

Other identifiers 2

IdentifierTypeStateIssuer
IN2373OtherINMEDICARE PTAN
300092797MedicaidIN

Other names 1

  • Commonwealth Pain And Spine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250312001351 IN DME Supplier - Physician - Interventional Pain Management 0941441919 Practice locations: Terre Haute, IN

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Pain Spine38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

3903 S 7th St
Ste 1A
Terre Haute, IN 47802
Phone (812) 237-1411

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1659107241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21890",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154115",
            "telephone_number": "502-907-0356",
            "fax_number": "502-919-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 S 7TH ST STE 1A",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025710",
            "telephone_number": "812-476-7111",
            "fax_number": "812-476-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH PAIN ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CARNES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-855-3919"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IN2373",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300092797",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Pain And Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.