Organization Active NPI

New York Pain Management Services PC

  • Pain Medicine (Anesthesiology) Physician
  • Brooklyn, NY
National Provider Identifier
1982659751
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
NEW YORK PAIN MANAGEMENT SERVICES PC
Practice address
360 Court St
Suite 3
Brooklyn, NY 11231-4353
Phone
(718) 858-3335
Fax
(718) 858-3229
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Vadim Kushnerik, M.D.NPI 1740244771
Title
President
Phone
(718) 858-3335

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
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

360 Court St
Suite 3
Brooklyn, NY 11231-4353

Mailing address

PO Box 5170
New York, NY 10087-5170
Phone (718) 422-5023

Other identifiers 1

IdentifierTypeStateIssuer
DC2133OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601001537 NY Part B Supplier - Clinic/Group Practice 1052393345 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

14 Wall St
Ste 6A
New York, NY 10005
Phone (212) 943-4999

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1982659751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5170",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100875170",
            "telephone_number": "718-422-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 COURT ST",
            "address_2": "SUITE 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112314353",
            "telephone_number": "718-858-3335",
            "fax_number": "718-858-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PAIN MANAGEMENT SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "KUSHNERIK",
        "authorized_official_first_name": "VADIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-858-3335",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC2133",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.