NPIMap

Organization Active NPI

Pain Rehabilitation & Critical Care Medical Group, Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Colton, CA
National Provider Identifier
1659569226
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
FNP36389 Issued in CA
Legal business name
PAIN REHABILITATION & CRITICAL CARE MEDICAL GROUP, INC.
Practice address
400 N Pepper Ave
2ND Floor-Dept. of Anesthesia
Colton, CA 92324-1801
Phone
(909) 580-2440
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Mark E Comunale, MDNPI 1245255041
Title
President
Phone
(909) 580-2440

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LC0200X FNP36389 CA
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X FNP36389 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
2ND Floor-Dept. of Anesthesia
Colton, CA 92324-1801

Mailing address

PO Box 765
Colton, CA 92324-0800
Phone (909) 580-2439

Other identifiers 1

IdentifierTypeStateIssuer
FNP36389OtherCAFICTITIOUS NAME PERMIT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000149 CA Part B Supplier - Clinic/Group Practice 7911067582 Receives reassigned benefits from 8 practitioners
Practice locations: Colton, CA

National Provider Directory

National Provider Directory

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": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1659569226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 765",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923240800",
            "telephone_number": "909-580-2439",
            "fax_number": "909-580-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "2ND FLOOR-DEPT. OF ANESTHESIA",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN REHABILITATION & CRITICAL CARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "COMUNALE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-580-2440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "CA",
            "license": "FNP36389",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "FNP36389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FICTITIOUS NAME PERMIT",
            "identifier": "FNP36389",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.