Organization Active NPI

Interventional Pain Medicine PC

  • Pain Medicine (Anesthesiology) Physician
  • Hollis, NY
National Provider Identifier
1669560504
Registry record updated Feb 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
INTERVENTIONAL PAIN MEDICINE PC
Practice address
19617 Hillside Ave
Hollis, NY 11423-2157
Phone
(718) 479-3900
Fax
(718) 479-1014
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2011

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

Authorized official

Name
Dr. Rajesh Patel, M.D.NPI 1841223781
Title
President
Phone
(718) 479-3900

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) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

19617 Hillside Ave
Hollis, NY 11423-2157

Mailing address

19617 Hillside Ave
Hollis, NY 11423-2157
Phone (718) 479-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070831000589 NY Part B Supplier - Clinic/Group Practice 3476646795 Receives reassigned benefits from 2 practitioners
Practice locations: Hollis, NY; South Richmond Hill, NY

National Provider Directory

National Provider Directory

Locations

11111 Liberty Ave
South Richmond Hill, NY 11419
Phone (347) 754-9442

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298678400000",
    "number": "1669560504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19617 HILLSIDE AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232157",
            "telephone_number": "718-479-3900",
            "fax_number": "718-479-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19617 HILLSIDE AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232157",
            "telephone_number": "718-479-3900",
            "fax_number": "718-479-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-02-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-479-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollis, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2011; 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.