Organization Active NPI

Pain Management Specialists of North Florida P a

  • Pain Medicine (Anesthesiology) Physician
  • St Augustine, FL
National Provider Identifier
1699708693
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PAIN MANAGEMENT SPECIALISTS OF NORTH FLORIDA P A
Practice address
1301 Plantation Island Dr S Ste 301a
St Augustine, FL 32080-3117
Phone
(904) 460-9555
Fax
(904) 460-0090
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Authorized official

Name
Dr. Raul A Monzon, M DNPI 1508885286
Title
Owner
Phone
(904) 460-9555

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

1301 Plantation Island Dr S Ste 301a
St Augustine, FL 32080-3117

Mailing address

1301 Plantation Island Dr S
Suite 301a
St Augustine, FL 32080-3117
Phone (904) 460-9555

Other practice location 1

199 S US Highway 17
Ste C
East Palatka, FL 32131
Phone (386) 325-4699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080308000030 FL Part B Supplier - Clinic/Group Practice 5092890525 Receives reassigned benefits from 1 practitioner
Practice locations: St Augustine, FL
O20100930018854 FL DME Supplier - Physician - Anesthesiology 5092890525 Practice locations: Saint Augustine, FL

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
10D1076699Pain Management Specialists of North F1301 Plantation Island Dr S Suite 301, Saint Augustine, FL 32080Certificate of waiverNov 19, 2027

National Provider Directory

National Provider Directory

Locations

199 S US Highway 17
Ste C
East Palatka, FL 32131
Phone (386) 325-4699

Practitioners & affiliated clinicians

Practitioners 1

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1699708693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S",
            "address_2": "SUITE 301A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803117",
            "telephone_number": "904-460-9555",
            "fax_number": "904-460-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 301A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803117",
            "telephone_number": "904-460-9555",
            "fax_number": "904-460-0090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 S US HIGHWAY 17",
            "address_2": "STE C",
            "address_purpose": "LOCATION",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "32131",
            "country_code": "US",
            "telephone_number": "386-325-4699",
            "fax_number": "904-460-0090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN MANAGEMENT SPECIALISTS OF NORTH FLORIDA P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "MONZON",
        "authorized_official_first_name": "RAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-460-9555",
        "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 St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.