NPIMap

Organization Active NPI

Interventional Pain Management Services LLC

  • Interventional Pain Medicine Physician
  • Florissant, MO
National Provider Identifier
1710018247
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
036112334 Issued in IL
Legal business name
INTERVENTIONAL PAIN MANAGEMENT SERVICES LLC
Practice address
261 Dunn Rd
Florissant, MO 63031-7928
Phone
(314) 830-2600
Fax
(314) 830-2648
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Dr. Mahendra Pal Gunapooti, MDNPI 1114034931
Title
President
Phone
(314) 830-2600

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
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 036112334 IL Primary

Addresses

Primary practice location

261 Dunn Rd
Florissant, MO 63031-7928

Mailing address

PO Box 650
Edwardsville, IL 62025-0650
Phone (314) 830-2600

Other practice location 1

2421 Corporate Ctr Ste 105
Granite City, IL 62040-4195
Phone (314) 830-2600

Other identifiers 1

IdentifierTypeStateIssuer
500000889MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050114000760 IL Part B Supplier - Clinic/Group Practice 3779532858 Receives reassigned benefits from 4 practitioners
Practice locations: Granite City, IL
O20050228000154 MO Part B Supplier - Clinic/Group Practice 3779532858 Receives reassigned benefits from 6 practitioners
Practice locations: Florissant, MO; Saint Peters, MO

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

2730 S Saint Peters Pkwy
Ste 200
Saint Peters, MO 63303
Phone (314) 830-2600

Practitioners & affiliated clinicians

Practitioners 6

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1710018247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620250650",
            "telephone_number": "314-830-2600",
            "fax_number": "314-830-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 DUNN RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317928",
            "telephone_number": "314-830-2600",
            "fax_number": "314-830-2648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2421 Corporate Ctr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620404195",
            "country_code": "US",
            "telephone_number": "314-830-2600",
            "fax_number": "314-830-2648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN MANAGEMENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "GUNAPOOTI",
        "authorized_official_first_name": "MAHENDRA",
        "authorized_official_middle_name": "PAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-830-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036112334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500000889",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.