NPIMap

Organization Active NPI

Northridge Pain Management Specialists Medical Corporation

  • Specialist
  • Northridge, CA
National Provider Identifier
1972683555
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTHRIDGE PAIN MANAGEMENT SPECIALISTS MEDICAL CORPORATION
Practice address
8331 Reseda Blvd
Northridge, CA 91324-4620
Phone
(818) 993-3428
Fax
(818) 993-3469
NPI assigned
Oct 17, 2006
Last updated
Apr 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

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

Authorized official

Name
Dr. Imad H Rasool, M.D.,PHD
Title
Ceo
Phone
(818) 993-3428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

8331 Reseda Blvd
Northridge, CA 91324-4620

Mailing address

PO Box 33278
Granada Hills, CA 91394-3278
Phone (818) 993-3428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000813 CA Part B Supplier - Clinic/Group Practice 5799684866 Receives reassigned benefits from 11 practitioners
Practice locations: Northridge, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1972683555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33278",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913943278",
            "telephone_number": "818-993-3428",
            "fax_number": "818-993-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8331 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244620",
            "telephone_number": "818-993-3428",
            "fax_number": "818-993-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE PAIN MANAGEMENT SPECIALISTS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "RASOOL",
        "authorized_official_first_name": "IMAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-993-3428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,PHD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.