SPINE CENTER OF PA LLC (NPI# 1104465681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104465681 |
| Entity Type | Organization |
| Organization Name | SPINE CENTER OF PA LLC |
| Practice Address |
2374 Village Common Dr Ste 100 Erie PA 16506-7201 |
| Mailing Address |
3060 Williams Dr Ste 510 Fairfax VA 22031-4648 |
| Practice Telephone | 8148337246 |
| Mailing Telephone | 7037891929 |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |
| Authorized Official Name | ANISH PATEL (OWNER) |
| Authorized Official Telephone | 3016200012 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2374 VILLAGE COMMON DR STE 100 |
| City | ERIE |
| State | PA |
| Zip Code | 16506-7201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518924208 | Heather L Szymczak | Physician Assistant | 2374 Village Common Dr Ste 100, Erie, PA 16506-7201 | 2006-04-27 |
| 1508472622 | Liam Cunningham | Physician Assistant | 2374 Village Common Dr Ste 100, Erie, PA 16506-7201 | 2020-09-23 |
| 1285847699 | Timothy Yee-tak Ko | Pain Medicine | 2374 Village Common Dr Ste 100, Erie, PA 16506-7201 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215582838 | Casey Smith | Behavioral Analyst | 4950 W 23rd Street, Suite 1, Erie, PA 16506 | 2019-08-09 |
| 1962916155 | Joseph Michael Moon | Chiropractor | 2921 W 26th St, Erie, PA 16506 | 2017-11-27 |
| 1053851550 | Lake Erie Music Therapy LLC | Music Therapist | 5672 Culpepper Dr., Erie, PA 16506 | 2017-03-02 |
| 1295152700 | Gabrielle Carr | Counselor | 2420 West 23rd St, Erie, PA 16506 | 2014-03-21 |
| 1407296973 | Carolyn Danner-bliss Pediatric Dietitian Services, LLC | Dietitian, Registered | 5105 Coventry Drive, Erie, PA 16506 | 2013-06-28 |
| 1962847772 | Philip J Dunn | Internal Medicine | 3615 Woodhaven Dr, Erie, PA 16506 | 2013-05-07 |
| 1619236684 | Joseph S. Serafini | Hearing Instrument Specialist | 2930 Mckee Rd, Erie, PA 16506 | 2012-05-11 |
| 1063788313 | Tatiana V Khochay | Registered Nurse | 2801 Burgundy Dr., Erie, PA 16506 | 2012-03-30 |
| 1699051318 | Krystyna Teresa Wozniak | Licensed Practical Nurse | 3912 East Boardwalk Place, Erie, PA 16506 | 2011-10-26 |
| 1033436324 | Alexis Jean Mustin | Social Worker | 3210 West 32nd Street, Erie, PA 16506 | 2010-04-26 |
| Find all providers in zip 16506 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922111764 | Erie Spine and Pain Management PC | Pain Medicine | 2620 Sigsbee Street, Erie, PA 16508 | 2006-08-16 |
| 1952935892 | Millcreek Community Hospital | Pain Medicine | 5401 Peach St Ste 3300, Erie, PA 16509-2601 | 2020-03-01 |
| 1942540588 | Pain Solutions of Erie LLC | Pain Medicine | 2409 State St, Suite 1r, Erie, PA 16503-1856 | 2013-02-19 |
| 1285847699 | Timothy Yee-tak Ko | Pain Medicine | 2374 Village Common Dr Ste 100, Erie, PA 16506-7201 | 2007-05-08 |
| 1366555104 | Jithendra Rai | Pain Medicine | 2620 Sigsbee Street, Erie, PA 16508 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063055200 | Sepa Lab - Bristol | Pain Medicine | 200 Rittenhouse Circle, Ste 1a East, Bristol, PA 19007-1619 | 2019-10-21 |
| 1033776257 | Restorative Pain Care LLC | Pain Medicine | 409 Portland Dr, Broomall, PA 19008-4120 | 2019-05-22 |
| 1104482850 | Keystone Pain Consultants & Interventional Spine Specialists PC | Pain Medicine | 2000 Oxford Dr Ste 303, Bethel Park, PA 15102-1841 | 2019-05-17 |
| 1891250767 | Regenerative Pain Specialist, PC | Pain Medicine | 725 Darby Paoli Rd, Villanova, PA 19085-1008 | 2019-02-05 |
| 1649766742 | Smr Pain Management | Pain Medicine | 213 Reeceville Rd Ste 10, Coatesville, PA 19320-1532 | 2018-07-02 |
| 1720463938 | Lancaster Medical Group, LLC | Pain Medicine | 233 College Ave Ste 101, Lancaster, PA 17603-3385 | 2015-07-29 |
| 1760725246 | Pittsburgh Pain Physicians | Pain Medicine | 119 Vip Dr Ste G015, Wexford, PA 15090-7976 | 2013-04-02 |
| 1417199217 | Kenneth Zahl | Pain Medicine | 175 E Brown St Ste 201b, E Stroudsburg, PA 18301-3098 | 2009-03-25 |
| 1316127376 | St. Luke's Physician Group, Inc. | Pain Medicine | 1534 Park Ave Ste 310, Quakertown, PA 18951-1087 | 2007-11-07 |
| 1790730570 | Sanjay M Madnani | Pain Medicine | 370 Middletown Blvd., Suite 508, Langhorne, PA 19047 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.