National Spine & Pain Centers – Interventional Pain Medicine Physician, NPI 1003884560
Interventional Pain Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for National Spine & Pain Centers
4960 SW 72ND AVE STE 405
MIAMI, FL 331555506
Phone: (469) 458-9222
Fax: (540) 918-7202
Type: Mailing
1750 TYSONS BLVD STE 120
MC LEAN, VA 221024227
Phone: (703) 560-8280
Fax: (703) 560-8214
Type: Location
11350, McCormick Road, Hunt Valley, Cockeysville, Baltimore County, Maryland, 21030, United States
EXECUTIVE PLAZA 1, SUITE 501
HUNT VALLEY, MD 210311002
Phone: (410) 329-1071
Fax: (410) 329-1059
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-05-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (768 days ago).
Enrollment records
3
Earliest due date
2024-04-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040617000167 | O | Clinic/Group Practice | DC | 2026-05-31 |
| O20071011000434 | O | Clinic/Group Practice | VA | 2024-04-30 |
| O20190509000017 | O | Clinic/Group Practice | MD | 2024-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33155)
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