Organization Active NPI

Center for Pain Control, PC

  • Specialist
  • Wyomissing, PA
National Provider Identifier
1851398408
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CENTER FOR PAIN CONTROL, PC
Practice address
1235 Penn Ave
Ste 302
Wyomissing, PA 19610-2100
Phone
(610) 374-2927
Fax
(610) 374-2909
NPI assigned
Jun 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Dr. Jason Thomas Bundy, M.D.NPI 1164644548
Title
Owner
Phone
(610) 374-2927

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1235 Penn Ave
Ste 302
Wyomissing, PA 19610-2100

Mailing address

1235 Penn Ave
Ste 302
Wyomissing, PA 19610-2100
Phone (610) 374-2927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040203000168 PA Part B Supplier - Clinic/Group Practice 5193618460 Receives reassigned benefits from 8 practitioners
Practice locations: Wyomissing, PA
O20140625002578 PA DME Supplier - Physician - Interventional Pain Management 5193618460 1 other NPI on this enrollment
Practice locations: Wyomissing, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1235 Penn Ave
Ste 302
Wyomissing, PA 19610
Phone (610) 374-2927

Practitioners & affiliated clinicians

Practitioners 8

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": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1851398408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 PENN AVE",
            "address_2": "STE 302",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102100",
            "telephone_number": "610-374-2927",
            "fax_number": "610-374-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 PENN AVE",
            "address_2": "STE 302",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102100",
            "telephone_number": "610-374-2927",
            "fax_number": "610-374-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PAIN CONTROL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "BUNDY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-374-2927",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.