Organization Active NPI

Kirby Pain Management and Rehabilitation

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Bentleyville, PA
National Provider Identifier
1811558075
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
KIRBY PAIN MANAGEMENT AND REHABILITATION
Practice address
55 Gosai Dr Ste 112
Bentleyville, PA 15314-1061
Phone
(412) 226-6399
Fax
(724) 239-2167
NPI assigned
Jun 27, 2019
Last updated
Jul 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Kristy Melville
Title
Office Manager
Phone
(412) 226-6399

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU Primary

Addresses

Primary practice location

55 Gosai Dr Ste 112
Bentleyville, PA 15314-1061

Mailing address

55 Gosai Dr Ste 112
Bentleyville, PA 15314-1061
Phone (412) 226-6399

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190709000119 PA Part B Supplier - Clinic/Group Practice 1153656517 Receives reassigned benefits from 1 practitioner
Practice locations: Bentleyville, PA

National Provider Directory

National Provider Directory

Locations

55 Gosai Dr
Bentleyville, PA 15314
Phone (412) 226-6399

55 Gosai Dr
Ste 112
Bentleyville, PA 15314
Phone (412) 226-6399

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1811558075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 GOSAI DR STE 112",
            "city": "BENTLEYVILLE",
            "state": "PA",
            "postal_code": "153141061",
            "telephone_number": "412-226-6399",
            "fax_number": "724-239-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 GOSAI DR STE 112",
            "city": "BENTLEYVILLE",
            "state": "PA",
            "postal_code": "153141061",
            "telephone_number": "412-226-6399",
            "fax_number": "724-239-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRBY PAIN MANAGEMENT AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "MELVILLE",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "412-226-6399"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentleyville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.