Active NPI
Merrimack Valley Pain Management Associates, P.C.
- Pain Clinic/Center
- Lawrence, MA
National Provider Identifier
1962652990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Clinic/Center
- License
- 213741
- Legal business name
- MERRIMACK VALLEY PAIN MANAGEMENT ASSOCIATES, P.C.
- Practice address
- 280 Merrimack St Ste 103
Lawrence, MA 01843-1780 - Phone
- (978) 685-2455
- Fax
- (978) 685-2459
- NPI assigned
- Sep 26, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Rami Rustum, MD
- Title
- President
- Phone
- (978) 685-2455
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Clinic/Center | 261QP3300X | 213741 | MA | Primary |
Addresses
Primary practice location
280 Merrimack St Ste 103
Lawrence, MA 01843-1780
Mailing address
280 Merrimack St Ste 103
Lawrence, MA 01843-1780
Phone (978) 685-2455
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962652990 | Other | MA | TRICARE |
| 614350100 | Other | MA | TUFTS |
| 614350100 | Other | MA | ACS |
| 9744801 | Medicaid | MA | |
| AA132832 | Other | MA | HEALTHCARE VALUE |
| 30217445 | Medicaid | NH | |
| AA132832 | Other | MA | HEALTH PLANS |
| M19676 | Other | MA | BC/BS |
| AA132832 | Other | MA | HARVARD |
| 1881694180 | Other | MA | BMC |
| 1881694180 | Other | MA | FALLON |
| 1962652990 | Other | MA | GIC UNICARE |
| 9111315 | Other | MA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
386 Merrimack St
Ste 3C
Methuen, MA 01844
Phone (978) 685-2455
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Interventional Pain Medicine Physician
- Lawrence, MA
- NPI 1881694180
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1517356800000",
"number": "1962652990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 MERRIMACK ST STE 103",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431780",
"telephone_number": "978-685-2455",
"fax_number": "978-685-2459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 MERRIMACK ST STE 103",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431780",
"telephone_number": "978-685-2455",
"fax_number": "978-685-2459"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERRIMACK VALLEY PAIN MANAGEMENT ASSOCIATES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2008-09-26",
"last_updated": "2018-01-31",
"status": "A",
"authorized_official_last_name": "RUSTUM",
"authorized_official_first_name": "RAMI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "978-685-2455",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QP3300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Pain",
"state": "MA",
"license": "213741",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1962652990",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "614350100",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACS",
"identifier": "614350100",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9744801",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE VALUE",
"identifier": "AA132832",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30217445",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLANS",
"identifier": "AA132832",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "M19676",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD",
"identifier": "AA132832",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC",
"identifier": "1881694180",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "1881694180",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GIC UNICARE",
"identifier": "1962652990",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9111315",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
- Merrimack Medical & Walk in Center, LLC
- Merrimack Medical & Walk in S LLC
- Merrimack Valley ABA Services Inc
- Merrimack Valley Health Services Inc
- Merrimack Valley Orthodontics LLC
- Merrimack Valley Pain Management PC
- Merrimack Valley Physical Therapy
- Merrimack Valley Transportation Inc.
- Margaret Louise Merrow, MSW
- Natalie Mersha
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.