Integrated Pain Management Medical Group, Inc.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

FNP28893 Issued in CA

Legal business name

INTEGRATED PAIN MANAGEMENT MEDICAL GROUP, INC.

Doing business as

Boomerang Healthcare

Practice address

450 N Wiget LN
Walnut Creek, CA 94598-2408

Phone

(925) 691-9806

Fax

(925) 407-2928

NPI assigned

Oct 13, 2006

Last updated

Dec 8, 2022By 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

Dr. Jacob A Rosenberg, M.D.NPI 1275537870

Title

President

Phone

(925) 691-9806

Specialties & licenses 1

Addresses

Other names 1

• Boomerang Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

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

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 223

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.

• Peter Abaci, MD

  • Interventional Pain Medicine Physician
  • Los Gatos, CA
  • NPI 1447200761
  Medicare reassignment Care Compare group NPD
• Kasra Amirdelfan, MD

  • Pain Medicine Physician
  • Walnut Creek, CA
  • NPI 1033113642
  Medicare reassignment Care Compare group NPD
• Khaled Azizi, D.C.

  • Chiropractor
  • Walnut Creek, CA
  • NPI 1669614426
  Medicare reassignment Care Compare group NPD
• Natalia Balytsky, M.D.

  • Anesthesiology Physician
  • Santa Rosa, CA
  • NPI 1326146705
  Medicare reassignment Care Compare group NPD
• Navjeet Kaur Boparai, MD

  • Physical Medicine & Rehabilitation Physician
  • Palo Alto, CA
  • NPI 1407025299
  Medicare reassignment Care Compare group NPD
• Chris Cake, DC

  • Chiropractor
  • Modesto, CA
  • NPI 1124164033
  Medicare reassignment Care Compare group NPD
• William Robert Campbell, D.O.

  • Orthopaedic Surgery of the Spine Physician
  • San Francisco, CA
  • NPI 1780611426

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michael J. Esposito, M.D.

  • Orthopaedic Surgery Physician
  • Santa Ana, CA
  • NPI 1285678755
  Medicare reassignment Care Compare group NPD
• Richard Fernandez, MD

  • Specialist
  • Daly City, CA
  • NPI 1265541346
  Medicare reassignment Care Compare group NPD
• Carl Walter Fieser Jr., M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1346515319
  Medicare reassignment Care Compare group NPD
• Douglas Grant, MD

  • Pain Medicine Physician
  • Walnut Creek, CA
  • NPI 1922002542
  Medicare reassignment Care Compare group NPD
• William Joshua Grief, MD

  • Interventional Pain Medicine Physician
  • Salinas, CA
  • NPI 1790873545
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1922198779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N WIGET LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982408",
            "telephone_number": "925-691-9806",
            "fax_number": "925-407-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N WIGET LN",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982408",
            "telephone_number": "925-691-9806",
            "fax_number": "925-407-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PAIN MANAGEMENT MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-691-9806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "FNP28893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boomerang Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tara Hannah Iqbal, PA-C

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.