ADVANCED PAIN MEDICINE PC NPI 1619233079

NPI Information

  • NPI: 1619233079
  • Provider Name: ADVANCED PAIN MEDICINE PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Doing Business As: ADVANCED PAIN MEDICINE MOON
  • CLIA Number: 39D1091457
  • Address: 1009 BEAVER GRADE RD
    STE 100
    MOON TWP, PA
    ZIP 15108
  • Phone: (724) 933-0300

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NPI Details

ADVANCED PAIN MEDICINE PC is a specialist in Moon Twp, PA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ADVANCED PAIN MEDICINE PC NPI is 1619233079. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advanced Pain Medicine Moon.

The provider's business location address is:

1009 BEAVER GRADE RD
STE 100
MOON TWP, PA
ZIP 15108-969
Phone: (724) 933-0300
Fax: (724) 933-0456

The provider's authorized official is Mark Lodico .
The authorized official title is Medical Director and has the following contact phone number (724) 933-0300.

The CLIA number assigned to this NPI record is 39D1091457 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/10/2012 and was last updated on 8/24/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10077653000002MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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