NPIMap

Organization Active NPI

Physical Medicine Associates, LTD

  • Interventional Pain Medicine Physician
  • Aldie, VA
National Provider Identifier
1730749102
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PHYSICAL MEDICINE ASSOCIATES, LTD
Practice address
24560 Southpoint Drive
Ste. 120
Aldie, VA 20105
Phone
(410) 329-1071
Fax
(410) 329-1054
NPI assigned
Jun 18, 2019
Last updated
Dec 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Authorized official

Name
Shaneka Tinch
Title
RCM Manager
Phone
(469) 458-9222

Specialties & licenses 1

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

Addresses

Primary practice location

24560 Southpoint Drive
Ste. 120
Aldie, VA 20105

Mailing address

4960 SW 72ND Ave Ste 405
Miami, FL 33155-5506
Phone (469) 458-9222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200210001973 VA DME Supplier - Physician - Interventional Pain Management 4981688835 Practice locations: Aldie, VA

Other NPIs with the same Medicare PAC ID 17

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

View all 17

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
49D2169862Physical Medicine Associates, LTD24560 Southpoint Drive, Ste 120, Aldie, VA 20105Certificate of waiverJul 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Physical Medicine Assoc LTD15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1730749102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 405",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555506",
            "telephone_number": "469-458-9222",
            "fax_number": "540-919-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24560 SOUTHPOINT DRIVE",
            "address_2": "STE. 120",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "20105",
            "telephone_number": "410-329-1071",
            "fax_number": "410-329-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "TINCH",
        "authorized_official_first_name": "SHANEKA",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "469-458-9222"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aldie, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.