Organization Active NPI

Pain Consultants of Michigan, PLC

  • Anesthesiology Physician
  • Saginaw, MI
National Provider Identifier
1679763569
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PAIN CONSULTANTS OF MICHIGAN, PLC
Practice address
1119 South Washington
Saginaw, MI 48601
Phone
(989) 752-1900
Fax
(989) 752-1901
NPI assigned
Jul 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Lakshmana MadalaNPI 1093742637
Title
Sole Proprietor
Phone
(989) 752-1900

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
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X

Addresses

Primary practice location

1119 South Washington
Saginaw, MI 48601

Mailing address

1119 South Washington
Saginaw, MI 48601
Phone (989) 752-1900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070928000225 MI Part B Supplier - Clinic/Group Practice 9638264146 Receives reassigned benefits from 2 practitioners
Practice locations: Saginaw, MI

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
23D1074847Pain Consultants of Michigan1119 S Washington Avenue, Saginaw, MI 48601Certificate of waiverOct 8, 2027

National Provider Directory

National Provider Directory

Locations

1119 S Washington Ave
Saginaw, MI 48601
Phone (989) 752-1900

Practitioners & affiliated clinicians

Practitioners 5

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": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1679763569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 SOUTH WASHINGTON",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48601",
            "telephone_number": "989-752-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 SOUTH WASHINGTON",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48601",
            "telephone_number": "989-752-1900",
            "fax_number": "989-752-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CONSULTANTS OF MICHIGAN, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "MADALA",
        "authorized_official_first_name": "LAKSHMANA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "989-752-1900"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.