INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC – Pain Clinic/Center, NPI 1013056969

INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC is a healthcare provider. based in Sartell, Minnesota. specializing in Pain Clinic/Center. The organization holds a License No. 41961 (MN). The NPI Number for INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC is 1013056969

Main info

Organization
Name
INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC
NPI
1013056969
Phone
(320) 229-1500
Address
2301 CONNECTICUT AVENUE SOUTH
Authorized Official
MRS. STACY KOWALKOWSKI ADMINISTRATOR R.N.
Enumeration Date
6 February 2007
Last Update Date
14 July 2015
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC

  • 2301 CONNECTICUT AVENUE SOUTH

    SARTELL, MN 563772474

    Phone: (320) 229-1500

    Fax: (320) 229-1505

    Mailing address matches the actual address.

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: 2004-02-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-10-31 (586 days ago).

Enrollment records

1

Earliest due date

2024-10-31

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
O20040223000665OClinic/Group PracticeMN2024-10-31

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.

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 56377)

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Reviews

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Frequently asked questions

How do I look up INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC by NPI?
Use NPI 1013056969 when you need to reference INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC in forms, claims, or directories.
Is INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC's NPI currently valid?
The extract we use shows INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC as active.
What field does INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC work in?
You can think of INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC as practicing within Pain Clinic/Center. Clinical services aligned with this taxonomy classification.
What location metadata exists for INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC?
The page summarizes Sartell, Minnesota for INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC; expand the address list for detail.
How can I contact INTERVENTIONAL PAIN & PHYSICAL MEDICINE CLINIC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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