Pain MD, PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

4301098964 Issued in MI

Legal business name

PAIN MD, PLLC

Practice address

5050 Villa Linde Pkwy
Suite a
Flint, MI 48532-3436

Phone

(810) 230-7400

NPI assigned

Dec 30, 2014

Last updated

Mar 31, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fayez Kotob, M.D.NPI 1346549219

Title

Owner/President

Phone

(810) 230-7400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Fayez Kotob, M.D., M.B.A.

  • Interventional Pain Medicine Physician
  • Flint, MI
  • NPI 1346549219
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1770971616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484800430",
            "telephone_number": "810-230-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 VILLA LINDE PKWY",
            "address_2": "SUITE A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323436",
            "telephone_number": "810-230-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-30",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "KOTOB",
        "authorized_official_first_name": "FAYEZ",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "810-230-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301098964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Flint, MI
• Providers in Flint, MI by specialty
• Pain Medicine (Anesthesiology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.