Organization Active NPI

Precision Interventional Pain Center PLLC

  • Pain Clinic/Center
  • Kennewick, WA
National Provider Identifier
1730945429
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
PRECISION INTERVENTIONAL PAIN CENTER PLLC
Practice address
5401 Ridgeline Dr Ste 130
Kennewick, WA 99338-1828
Phone
(509) 396-7966
NPI assigned
Feb 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Michael Kolczynski, MDNPI 1801236971
Title
Owner
Phone
(509) 396-7966

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 Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

5401 Ridgeline Dr Ste 130
Kennewick, WA 99338-1828

Mailing address

5401 Ridgeline Dr Ste 130
Kennewick, WA 99338-1828
Phone (509) 396-7966

Other names 1

  • Precision Interventional Pain Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240604004366 WA Part B Supplier - Clinic/Group Practice 5092257113 Receives reassigned benefits from 1 practitioner
Practice locations: Kennewick, WA

National Provider Directory

National Provider Directory

Locations

5401 Ridgeline Dr
Ste 130
Kennewick, WA 99338
Phone (509) 396-7966

5401 Ridgeline Dr
Kennewick, WA 99338
Phone (509) 396-7966

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": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1730945429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 RIDGELINE DR STE 130",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381828",
            "telephone_number": "509-396-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 RIDGELINE DR STE 130",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381828",
            "telephone_number": "509-396-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION INTERVENTIONAL PAIN CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "KOLCZYNSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-396-7966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Interventional Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.