Keystone Pain Center LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD036737L Issued in PA

Legal business name

KEYSTONE PAIN CENTER LLC

Practice address

468 Northampton St
Edwardsville, PA 18704-4566

Phone

(570) 718-1307

Fax

(570) 718-1309

NPI assigned

Feb 27, 2008

Organization subpart

No

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

Authorized official

Name

Dasa Satyam, MD

Title

Physician

Phone

(570) 718-1307

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1902075617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N MAIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187024411",
            "telephone_number": "570-208-5571",
            "fax_number": "570-208-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 NORTHAMPTON ST",
            "city": "EDWARDSVILLE",
            "state": "PA",
            "postal_code": "187044566",
            "telephone_number": "570-718-1307",
            "fax_number": "570-718-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "SATYAM",
        "authorized_official_first_name": "DASA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "570-718-1307",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD036737L",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD036737L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021049560001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Edwardsville, PA
• Providers in Edwardsville, PA by specialty
• Pain Medicine (Anesthesiology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.