NPIMap

Organization Active NPI

Advanced Spine and Pain LLC

  • Pain Medicine Physician
  • Toms River, NJ
National Provider Identifier
1780157222
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
ADVANCED SPINE AND PAIN LLC
Practice address
40 Bey Lea Rd Ste C203
Toms River, NJ 08753-2974
Phone
(888) 985-2727
Fax
(856) 779-0211
NPI assigned
Jan 8, 2019
Organization subpart
Yes
Parent organization
ADVANCED SPINE AND PAIN, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Damean William Freas
Title
Ceo
Phone
(888) 985-2727

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

40 Bey Lea Rd Ste C203
Toms River, NJ 08753-2974

Mailing address

201 Defense Hwy Ste 205
Annapolis, MD 21401-7096
Phone (888) 985-2727

Other names 1

  • Relievus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190213002313 NJ DME Supplier - Multi-Specialty - Physician 0648358234 Practice locations: Toms River, NJ

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Advanced Spine and Pain LLC13 organizations share this tax ID, including this one
Part of
Advanced Spine and Pain LLC

Other organizations with this tax ID 12

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

Locations

432 Lakehurst Rd
Fl 1
Toms River, NJ 08755

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1780157222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017096",
            "telephone_number": "888-985-2727",
            "fax_number": "856-779-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BEY LEA RD STE C203",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532974",
            "telephone_number": "888-985-2727",
            "fax_number": "856-779-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINE AND PAIN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED SPINE AND PAIN, LLC",
        "enumeration_date": "2019-01-08",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "FREAS",
        "authorized_official_first_name": "DAMEAN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-985-2727"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Relievus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Relievus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.