NPIMap

Organization Active NPI

Michigan Interventional Pain Associates PLLC

  • Anesthesiology Physician
  • West Bloomfield, MI
National Provider Identifier
1861819161
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MICHIGAN INTERVENTIONAL PAIN ASSOCIATES PLLC
Practice address
2300 Haggerty Rd
Suite 2100
West Bloomfield, MI 48323-2184
Phone
(248) 624-7246
NPI assigned
Mar 25, 2014
Last updated
Jan 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Authorized official

Name
Steven Wiener, MDNPI 1518073626
Title
Owner
Phone
(248) 624-7246

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

2300 Haggerty Rd
Suite 2100
West Bloomfield, MI 48323-2184

Mailing address

2300 Haggerty Rd Ste 2100
West Bloomfield, MI 48323-2191
Phone (248) 624-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140521002054 MI Part B Supplier - Clinic/Group Practice 4385867266 Receives reassigned benefits from 39 practitioners
Practice locations: Troy, MI; Utica, MI; West Bloomfield, MI

National Provider Directory

National Provider Directory
Tax ID family
Michigan Interventional Pain Assoc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

130 Town Center Dr
Ste 130
Troy, MI 48084
Phone (248) 624-7246

2300 Haggerty Rd
Ste 2100
West Bloomfield, MI 48323
Phone (248) 624-7246

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1861819161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD STE 2100",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232191",
            "telephone_number": "248-624-7246",
            "fax_number": "248-624-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 2100",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-624-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INTERVENTIONAL PAIN ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "WIENER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-624-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.