NPIMap

Organization Active NPI

Pain Doctors of America PLLC

  • Interventional Pain Medicine Physician
  • New York, NY
National Provider Identifier
1992264469
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
PAIN DOCTORS OF AMERICA PLLC
Practice address
290 Madison Ave
New York, NY 10017-6308
Phone
(973) 826-2636
Fax
(973) 779-7385
NPI assigned
Mar 14, 2019
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Michael Nguyen, MDNPI 1730380478
Title
Authorized Official
Phone
(332) 282-5622

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)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

290 Madison Ave
New York, NY 10017-6308

Mailing address

576 Valley Rd Ste 233
Wayne, NJ 07470-3526
Phone (917) 920-3006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20190509000063 NJ Part B Supplier - Clinic/Group Practice 9830431006 Receives reassigned benefits from 8 practitioners
Practice locations: Bloomfield, NJ; Clifton, NJ; Edgewater, NJ; Hoboken, NJ; Paramus, NJ; West Orange, NJ; Woodland Park, NJ
O20211104002765 NY Part B Supplier - Clinic/Group Practice 9830431006 Receives reassigned benefits from 10 practitioners
Practice locations: Brooklyn, NY; Staten Island, NY; New York, NY; Jericho, NY; Hartsdale, NY; Bronx, NY
O20220124000602 NJ DME Supplier - Physician - Interventional Pain Management 9830431006 Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

70 Hudson St
Lowr
Hoboken, NJ 07030

188 Montague St
Fl 10
Brooklyn, NY 11201
Phone (631) 450-3772

280 N Central Ave
Ste 450
Hartsdale, NY 10530
Phone (212) 518-4562

350 Jericho Tpke
Ste 310
Jericho, NY 11753
Phone (631) 450-3772

290 Madison Ave
New York, NY 10017
Phone (973) 826-2636

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1992264469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 VALLEY RD STE 233",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703526",
            "telephone_number": "917-920-3006",
            "fax_number": "201-377-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176308",
            "telephone_number": "973-826-2636",
            "fax_number": "973-779-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN DOCTORS OF AMERICA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "332-282-5622",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.