NPIMap

Organization Active NPI

Pain Institute of Southern Arizona Pisa PC

  • Interventional Pain Medicine Physician
  • Tucson, AZ
National Provider Identifier
1669934014
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC
Practice address
7140 E Rosewood Street
Suite 110
Tucson, AZ 85710
Phone
(520) 318-5035
Fax
(520) 795-9953
NPI assigned
Apr 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Mr. John H Cole
Title
Ceo
Phone
(520) 490-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

7140 E Rosewood Street
Suite 110
Tucson, AZ 85710

Mailing address

4881 E Grant Road
Suite 101
Tucson, AZ 85712
Phone (520) 318-6035

Other identifiers 1

IdentifierTypeStateIssuer
954926MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190716000998 AZ DME Supplier - Physician - Interventional Pain Management 4688615362 Practice locations: Tucson, AZ

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1669934014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 E GRANT ROAD",
            "address_2": "SUITE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-318-6035",
            "fax_number": "520-795-9953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7140 E ROSEWOOD STREET",
            "address_2": "SUITE 110",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85710",
            "telephone_number": "520-318-5035",
            "fax_number": "520-795-9953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2021-05-12",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-490-4200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "954926",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.