New Jersey Spine and Pain Institute LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

25MA07777500 Issued in NJ

Legal business name

NEW JERSEY SPINE AND PAIN INSTITUTE LLC

Practice address

19 E 27TH St
Bayonne, NJ 07002-4608

Phone

(201) 436-0033

Fax

(201) 436-0079

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Joseph G. a. Ibrahim, MDNPI 1225068281

Title

President

Phone

(201) 436-0033

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY3 enrollments

Enrollment records 3

Locations

Practitioners 8

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

• Joseph G.a. Ibrahim, M.D.

  • Specialist
  • Bayonne, NJ
  • NPI 1225068281

  NY

  Medicare reassignment Care Compare group NPD Authorized official
• Shasta Victoria Grimes Castro-Penullar, BSPT

  • Physical Therapist
  • Jersey City, NJ
  • NPI 1699819730
  Medicare reassignment Care Compare group NPD
• Nedaa Sharobeem, MD

  • Internal Medicine Physician
  • Bayonne, NJ
  • NPI 1750602264
  Medicare reassignment Care Compare group NPD
• Jaclyn Valdes, APN

  • Nurse Practitioner
  • Belleville, NJ
  • NPI 1982075255
  Medicare reassignment Care Compare group NPD
• Tracy Puza, PA

  • Surgical Physician Assistant
  • Staten Island, NY
  • NPI 1245452200

  NJ

  Medicare reassignment Care Compare group
• Lilian Orellana

  • Gerontology Nurse Practitioner
  • Teaneck, NJ
  • NPI 1093312068
  Medicare reassignment NPD
• Daniel S Wong, DPT

  • Physical Therapist
  • Wayne, NJ
  • NPI 1326298555
  Medicare reassignment NPD
• Victoria Hohmann, FNP-BC

  • Nurse Practitioner
  • Brooklyn, NY
  • NPI 1154042547

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1972630788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E 27TH ST",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024608",
            "telephone_number": "201-436-0033",
            "fax_number": "201-436-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY SPINE AND PAIN INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "G. A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-436-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NJ",
            "license": "25MA07777500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Jersey CVS Pharmacy LLC (CVS Pharmacy #11203)
• New Jersey Imaging Associates, PC
• New Jersey Institute of Balance, LLC
• New Jersey Professional Medical Services LLC
• New Jersey Spine & Pain Institute LLC
• New Life Medical
• New Pathway Counseling Services
• Lindsey Hoang-VI Nguyen, DO
• Michael John Nicholson, DO
• Maria E. Nieves, NP

• Pain Clinic/Center in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Pain Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; 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.