INTERVENTIONAL SPINE AND PAIN INSTITUTE LLC
NPI 1093695504
Pain Medicine - Interventional Pain Medicine in Melbourne, FL

Q: What is Interventional Spine And Pain Institute LLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Active since September 04, 2025CLIA 10D2335162 · Waiver

6559 N WICKHAM RD, MELBOURNE, FL 32940(772) 360-1997(772) 492-3541 Get Directions Write a Review

NPPES record last updated: September 26, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Interventional Spine And Pain Institute Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTERVENTIONAL SPINE AND PAIN INSTITUTE LLC (NPI 1093695504) is a healthcare organization registered as an interventional pain medicine in Melbourne, Florida and active in the NPI registry since September 2025. The organization holds a CLIA Waiver certificate valid through December 7, 2027 and lists Phaedra L Shudra, Credentialing And Contracting Speci, as its authorized official.

NPPES Registry Identity

NPI1093695504

Entity TypeOrganization

Primary Taxonomy208VP0014X

Legal Business NameINTERVENTIONAL SPINE AND PAIN INSTITUTE LLC

Location Address6559 N WICKHAM RDMelbourne, FL 32940-2052

Mailing Address777 37th St Ste C101Vero Beach, FL 32960-7301 · (772) 360-1997 · Fax (772) 492-3541

Phone(772) 360-1997

Fax(772) 492-3541

Organization SubpartNo

Authorized OfficialPhaedra L ShudraCredentialing And Contracting Speci · (813) 785-4861

Enumeration DateSeptember 4, 2025

Last NPPES UpdateSeptember 26, 2025

NPPES CertifiedSeptember 26, 2025

✔ NPI 1093695504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Also ListedAnesthesiologyTaxonomy 207L00000X

Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X

Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X

6559 N WICKHAM RD, Melbourne, FL 32940

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2335162

Interventional Spine And Pain Institute LLC · Melbourne, FL

Active · expires Dec 7, 2027

CLIA Number10D2335162

Laboratory TypePhysician Office

Certificate Effective DateDecember 8, 2025

Certificate Expiration DateDecember 7, 2027

Laboratory DirectorMichael F. Esposito

Laboratory Phone(321) 374-6850

Laboratory LocationInterventional Spine And Pain Institute LLC6559 N Wickham Rd Unit C-102, Melbourne, FL 32940

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FLORIDA DERMATOLOGY PLASTIC SURGERY LLC

Dermatology

6559 N WICKHAM RD, SUITE 105
MELBOURNE, FL 32940

Brevard County (321) 345-0552

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Interventional Spine And Pain Institute LLC's NPI number?

The NPI number for Interventional Spine And Pain Institute LLC is 1093695504. It was assigned to this organization in the NPPES registry on September 4, 2025.

Where is Interventional Spine And Pain Institute LLC located?

Interventional Spine And Pain Institute LLC is located at 6559 N Wickham Rd, Melbourne, FL 32940. The listed phone number is (772) 360-1997.

What is Interventional Spine And Pain Institute LLC's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Does Interventional Spine And Pain Institute LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2335162) is associated with this NPI, valid through December 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Interventional Spine And Pain Institute LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Interventional Spine And Pain Institute LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Interventional Spine And Pain Institute LLC was last updated on September 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.