Organization Active NPI

Pain Management Institute LLC

  • Pain Clinic/Center
  • Wooster, OH
National Provider Identifier
1992972111
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
PAIN MANAGEMENT INSTITUTE LLC
Practice address
546 Winter St
Wooster, OH 44691-2300
Phone
(330) 202-5580
Fax
(330) 202-5581
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Dr. Ayman Harris Basali, MDNPI 1861457509
Title
Medical Director
Phone
(330) 202-5580

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
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

546 Winter St
Wooster, OH 44691-2300

Mailing address

27739 S Woodland Rd
Pepper Pike, OH 44124-5633
Phone (216) 595-1328

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080530000454 OH Part B Supplier - Clinic/Group Practice 3274603493 Receives reassigned benefits from 3 practitioners
Practice locations: Wooster, OH

National Provider Directory

National Provider Directory

Locations

546 Winter St
Ste 200
Wooster, OH 44691
Phone (330) 202-5580

1761 Beall Ave
Ste A
Wooster, OH 44691
Phone (330) 202-5580

Practitioners & affiliated clinicians

Practitioners 9

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": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1992972111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27739 S WOODLAND RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245633",
            "telephone_number": "216-595-1328",
            "fax_number": "330-202-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 WINTER ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912300",
            "telephone_number": "330-202-5580",
            "fax_number": "330-202-5581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "BASALI",
        "authorized_official_first_name": "AYMAN",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "330-202-5580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.