PAIN TREATMENT CENTERS OF GEORGIA LLC – Clinic/Center, NPI 1619702792

PAIN TREATMENT CENTERS OF GEORGIA LLC is a healthcare provider. based in Hinesville, Georgia. specializing in Clinic/Center. The NPI Number for PAIN TREATMENT CENTERS OF GEORGIA LLC is 1619702792

Main info

Organization
Name
PAIN TREATMENT CENTERS OF GEORGIA LLC
NPI
1619702792
Phone
(912) 910-3777
Address
604 W OGLETHORPE HWY
Authorized Official
VADIM PETROV-KONDRATOV OWNER MD
Enumeration Date
6 September 2024
Last Update Date
6 September 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience22
Completeness75
Years active:1State licenses:0Digital endpointsOther names

Provider Addresses for PAIN TREATMENT CENTERS OF GEORGIA LLC

  • 604 W OGLETHORPE HWY

    HINESVILLE, GA 313134415

    Phone: (912) 910-3777

    Fax: (912) 292-0005

    Type: Mailing

  • 6606 ABERCORN ST

    SAVANNAH, GA 314055817

    Phone: (912) 910-3777

    Fax: (912) 292-0005

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2025-03-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20250312000054OPhysician - Interventional Pain ManagementGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 31313)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the 10-digit NPI for PAIN TREATMENT CENTERS OF GEORGIA LLC?
PAIN TREATMENT CENTERS OF GEORGIA LLC — NPI 1619702792 — is the standard way to identify this listing.
Is PAIN TREATMENT CENTERS OF GEORGIA LLC listed as active for patients and plans?
The listing shows PAIN TREATMENT CENTERS OF GEORGIA LLC as active in the NPI system.
What healthcare role does PAIN TREATMENT CENTERS OF GEORGIA LLC hold?
Scheduling teams often label PAIN TREATMENT CENTERS OF GEORGIA LLC under Clinic/Center. Clinical services aligned with this taxonomy classification.
Does PAIN TREATMENT CENTERS OF GEORGIA LLC list a practice location?
Patients near Hinesville, Georgia may find PAIN TREATMENT CENTERS OF GEORGIA LLC in results; validate coverage separately.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

Similar Providers

124 WEST ML KING JR DR
NPI: 1730353012

ADVENT CARE SYSTEMS

Clinic/Center
745 SOUTH MAIN STREET
NPI: 1679919195
Liberty Regional Medical Center, 462, Elma G Miles Parkway, Deer Run Estates, Mill Creek, Hinesville, Liberty County, Georgia, 31313, United States
NPI: 1063903011
604 W OGLETHORPE HWY
NPI: 1548931249