NPIMap

Organization Active NPI

Synergy Spine and Pain Center, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Glenn Dale, MD
National Provider Identifier
1912413659
Registry record updated Sep 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
D76707 Issued in MD
Legal business name
SYNERGY SPINE AND PAIN CENTER, LLC
Practice address
12150 Annapolis Rd Ste 209
Glenn Dale, MD 20769
Phone
(413) 798-0399
NPI assigned
Dec 18, 2017
Last updated
Sep 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2020

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

Authorized official

Name
Dr. Madhavi Chada, MDNPI 1922212166
Title
Owner
Phone
(240) 929-6652

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X MD
Pain Medicine (Anesthesiology) Physician 207LP2900X D76707 MD Primary

Addresses

Primary practice location

12150 Annapolis Rd Ste 209
Glenn Dale, MD 20769

Mailing address

12150 Annapolis Rd Ste 209
Glenn Dale, MD 20769-9183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180316000708 DC Part B Supplier - Clinic/Group Practice 5890057590 Receives reassigned benefits from 7 practitioners
Practice locations: Fort Washington, MD; Glenn Dale, MD; Silver Spring, MD
O20191126001766 MD DME Supplier - Physician - Interventional Pain Management 5890057590 Practice locations: Glenn Dale, MD

National Provider Directory

National Provider Directory
Tax ID family
Synergy Spine and Pain Center2 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.

Locations

11233 Lockwood Dr
Unit 6G
Silver Spring, MD 20901
Phone (240) 929-6652

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599436800000",
    "number": "1912413659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 209",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 209",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "20769",
            "telephone_number": "413-798-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY SPINE AND PAIN CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A",
        "authorized_official_last_name": "CHADA",
        "authorized_official_first_name": "MADHAVI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-929-6652",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MD",
            "license": "D76707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.