NPIMap

Organization Active NPI

Pain Management Specialists Medical Group

  • Specialist
  • Santa Maria, CA
National Provider Identifier
1679857510
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
Practice address
314 S Stratford Ave
Santa Maria, CA 93454-5903
Phone
(805) 922-5655
Fax
(805) 922-5889
NPI assigned
Oct 10, 2011
Last updated
Jan 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Authorized official

Name
Boris Pilch, MD
Title
Managing Partner
Phone
(805) 786-4878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

314 S Stratford Ave
Santa Maria, CA 93454-5903

Mailing address

PO Box 4659
San Luis Obispo, CA 93403-4659
Phone (805) 922-5655

Other identifiers 1

IdentifierTypeStateIssuer
GR0105740MedicaidCA

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
05D1087051Pain Management Specialists314S Stratford Ave, Santa Maria, CA 93454Certificate of waiverJul 23, 2026

National Provider Directory

National Provider Directory

Locations

5000 San Palo Rd
Ste 101
Atascadero, CA 93422
Phone (805) 470-1700

1201 E Ocean Ave
Ste B
Lompoc, CA 93436
Phone (805) 735-1155

1300 E Cypress St
Ste E1A
Santa Maria, CA 93454
Phone (805) 597-8386

314 S Stratford Ave
#M
Santa Maria, CA 93454
Phone (805) 922-5655

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1679857510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4659",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934034659",
            "telephone_number": "805-922-5655",
            "fax_number": "805-922-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S STRATFORD AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545903",
            "telephone_number": "805-922-5655",
            "fax_number": "805-922-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "PILCH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-786-4878",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0105740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.