East End Pain Management, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

EAST END PAIN MANAGEMENT, LLC

Practice address

365 County Road 39a
Suite 15 & 16
Southampton, NY 11968

Phone

(631) 702-2300

Fax

(631) 702-2303

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Juan J. Gargiulo, M.D.NPI 1780639419

Title

Medical Director

Phone

(631) 702-2300

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• East End Pain Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Juan J Gargiulo, MD

  • Interventional Pain Medicine Physician
  • Southampton, NY
  • NPI 1780639419
  Medicare reassignment Authorized official
• Frederick Bowman, P.T.

  • Physical Therapist
  • Westhampton Beach, NY
  • NPI 1205997566
  NPD (past)
• Eileen Bridget Flynn Richards, NP

  • Adult Health Nurse Practitioner
  • Centereach, NY
  • NPI 1780671446
  NPD (past)
• Jonathan Levitsky, MD

  • Anesthesiology Physician
  • Southampton, NY
  • NPI 1023046539
  NPD (past)
• Jeffrey M Muller, MD

  • Anesthesiology Physician
  • Southampton, NY
  • NPI 1760436026
  NPD (past)
• Scott Silverberg

  • Anesthesiology Physician
  • Southampton, NY
  • NPI 1063467744
  NPD (past)
• Frederick Jay Soroka, DC

  • Chiropractor
  • Southampton, NY
  • NPI 1205028222
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1902852247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 COUNTY ROAD 39A",
            "address_2": "SUITE 15 & 16",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-702-2300",
            "fax_number": "631-702-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 COUNTY ROAD 39A",
            "address_2": "SUITE 15 & 16",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "11968",
            "telephone_number": "631-702-2300",
            "fax_number": "631-702-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST END PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "GARGIULO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "631-702-2300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA6752",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMP",
            "identifier": "361034200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East End Pain Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Lynn Durning, L.AC.
• Peter Q Dyner, D.P.M.
• East End Anesthesiologists LLC
• East End Kids Psy, SLP, OT & PT Serv. PLLC
• East End Kids Therapy, Inc.
• East Ends Tooth Ferry Pediatric Dentistry PLLC
• Eastern Long Island General and Vascular Surgery PC
• Eastern Long Island Surgery PC
• Eastern Suffolk Urology PC
• Deborah Edelman, LMSW

• Pain Medicine (Anesthesiology) Physician in Southampton, NY
• Providers in Southampton, NY by specialty
• Pain Medicine (Anesthesiology) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.