Organization Active NPI

Florida Pain Management Associates PA.

  • Interventional Pain Medicine Physician
  • Sebastian, FL
National Provider Identifier
1992719744
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME62542 Issued in FL
Legal business name
FLORIDA PAIN MANAGEMENT ASSOCIATES PA.
Practice address
13825 US Highway 1
Sebastian, FL 32958-3232
Phone
(772) 388-9998
Fax
(772) 388-9742
NPI assigned
Jul 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Authorized official

Name
Dr. Harold J Cordner, M.D.NPI 1487641924
Title
President
Phone
(772) 388-9998

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: 193400000X SINGLE SPECIALTY GROUP 208VP0014X ME62542 FL Primary

Addresses

Primary practice location

13825 US Highway 1
Sebastian, FL 32958-3232

Mailing address

13825 US Highway 1
Sebastian, FL 32958-3232
Phone (772) 388-9998

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060811000044 FL Part B Supplier - Clinic/Group Practice 3678532470 Receives reassigned benefits from 4 practitioners
Practice locations: Sebastian, FL; Vero Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1098963Florida Pain Management Associates13825 US 1, Sebastian, FL 32958Certificate of waiverApr 30, 2027

National Provider Directory

National Provider Directory

Locations

960 37th Pl
Ste 102
Vero Beach, FL 32960
Phone (772) 770-6901

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1992719744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13825 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583232",
            "telephone_number": "772-388-9998",
            "fax_number": "772-388-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13825 US HIGHWAY 1",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583232",
            "telephone_number": "772-388-9998",
            "fax_number": "772-388-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PAIN MANAGEMENT ASSOCIATES PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "CORDNER",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-388-9998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME62542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.