GONZAGA INTERVENTIONAL PAIN MANAGEMENT
NPI 1073608253
Pain Medicine - Pain Medicine in Lavale, MD
NPI Status: Active since October 04, 2006
Contact Information
957 NATIONAL HWY
LAVALE, MD
ZIP 21502
Phone: (240) 362-7128
Fax: (240) 362-7129
- Organization
- Pain Medicine
- Pain Medicine
- CLIA Number: 21D2109053
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-06-2026
About GONZAGA INTERVENTIONAL PAIN MANAGEMENT
This page provides the complete NPI Profile along with additional information for Gonzaga Interventional Pain Management, a provider established in Lavale, Maryland operating as a Pain Medicine. The healthcare provider is registered in the NPI registry with number 1073608253 assigned on October 2006. The practitioner's primary taxonomy code is 208VP0000X with license number D222148 (MD). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Gonzaga Interventional Pain Management. The authorized official of this NPI record is Melvin R Gonzaga Md (Owner)
- NPI
- 1073608253
- Provider Legal Name
- GARRETT ANESTHESIA AND PAIN MANAGEMENT
- Other Organization Name
- GONZAGA INTERVENTIONAL PAIN MANAGEMENT
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 957 NATIONAL HWY LAVALE, MD 21502
- Location Phone
- (240) 362-7128
- Location Fax
- (240) 362-7129
- Mailing Address
- 957 NATIONAL HWY LAVALE, MD 21502
- Mailing Phone
- (240) 362-7128
- Mailing Fax
- (240) 362-7129
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-04-2006
- Last Update Date
- 09-04-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pain Medicine Pain Medicine
- Taxonomy Code
- 208VP0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- D222148
- License State
- MD
- Taxonomy Description
- Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 961521100 | MEDICAID (05) | MD |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 21D2109053
- Facility Type
- Physician Office
- Certificate Effective Date
- July 07, 2024
- Certificate Expiration Date
- July 06, 2026
- Laboratory Director
- GEORGE L. RYALS
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Gonzaga Interventional Pain Management after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1073608253, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 47 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
LAVALE, MD 21502
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073608253, enumerated as an "organization" on October 04, 2006.
The provider is located at 957 NATIONAL HWY LAVALE, MD 21502 and the phone number is (240) 362-7128.
Pain Medicine with taxonomy code 208VP0000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
