Spine and Pain Specialty Care LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

SPINE AND PAIN SPECIALTY CARE LLC

Practice address

219 S Broad St
Elizabeth, NJ 07202-3453

Phone

(908) 818-1600

Fax

(908) 818-1601

NPI assigned

Nov 10, 2014

Last updated

Jul 25, 2016By 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

Edward Shen, MDNPI 1093973174

Title

Pain Physician

Phone

(908) 818-1600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Locations

Practitioners 3

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.

• Edward Shen, MD

  • Pain Medicine (Anesthesiology) Physician
  • Elizabeth, NJ
  • NPI 1093973174
  Medicare reassignment NPD Authorized official
• Michaela Bukoski, PA-C

  • Physician Assistant
  • Wayne, NJ
  • NPI 1992352199
  Medicare reassignment
• Edie P Shen, M.D.

  • Hospitalist Physician
  • Seattle, WA
  • NPI 1982657946
  NPD (past)

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1881090413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 S BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023453",
            "telephone_number": "908-818-1600",
            "fax_number": "908-818-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 S BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023453",
            "telephone_number": "908-818-1600",
            "fax_number": "908-818-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND PAIN SPECIALTY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "SHEN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PAIN PHYSICIAN",
        "authorized_official_telephone_number": "908-818-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dara Jeanne Sperber, DPM
• Spinal Care of Elizabeth
• Spinal Diagnostics LLC
• Spine & Rehabilitation Center of Elizabeth
• Spine and Health Care of Elizabeth
• Spine and Rehabilitation Center of Jersey City LLC
• Spine and Rehabilitation Centers of New Jersey LLC
• Spinecare Chiropractic Rehab Center,PA
• Springfield Pediatrics, P.a. (Springfield Pediatrics)
• St Cyrill Pharmacy LLC (Alexandria Pharmacy)

• Pain Medicine (Anesthesiology) Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Pain Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.