PAIN TREATMENT CENTERS OF GEORGIA LLC
NPI 1134909542
Clinic/Center - Pain in Richmond Hill, GA
About Pain Treatment Centers Of Georgia Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PAIN TREATMENT CENTERS OF GEORGIA LLC (NPI 1134909542) is a healthcare organization registered as a pain in Richmond Hill, Georgia and active in the NPI registry since October 2023. The organization holds a CLIA Certificate of Compliance certificate valid through October 24, 2027 and lists Vadim Petrov-kondratov, Physician Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pain Treatment Centers Of Georgia Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Pain Treatment Centers Of Georgia LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Richmond Hill, GA 31324
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Compliance 11D2258890
Pain Treatment Centers Of Georgia LLC · Hinesville, GAFrequently 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 Pain Treatment Centers Of Georgia LLC's NPI number?
The NPI number for Pain Treatment Centers Of Georgia LLC is 1134909542. It was assigned to this organization in the NPPES registry on October 3, 2023.
Where is Pain Treatment Centers Of Georgia LLC located?
Pain Treatment Centers Of Georgia LLC is located at 3760 Us Highway 17 Unit 11, Richmond Hill, GA 31324. The listed phone number is (912) 910-3777.
What is Pain Treatment Centers Of Georgia LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Pain, with taxonomy code 261QP3300X.
Is Pain Treatment Centers Of Georgia LLC enrolled in Medicare?
Yes. Pain Treatment Centers Of Georgia LLC is registered in the Medicare PECOS enrollment system.
When is Pain Treatment Centers Of Georgia LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Pain Treatment Centers Of Georgia LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Pain Treatment Centers Of Georgia LLC, in Interventional Pain Management, Nurse Practitioner and Pain Management. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Pain Treatment Centers Of Georgia LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 11D2258890) is associated with this NPI, valid through October 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Pain Treatment Centers Of Georgia LLC was last updated on June 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Pain Treatment Centers Of Georgia Llc · NPI 1134909542
Pain organization in Richmond Hill, Georgia. Organization record, active in the CMS NPPES registry since October 3, 2023.
## Identity
- **NPI:** 1134909542 (Entity type: Organization)
- **Enumerated:** October 3, 2023
- **Primary specialty:** Clinic/Center - Pain · taxonomy 261QP3300X
- **Organization subpart:** No
- **Authorized official:** Vadim Petrov-Kondratov, PHYSICIAN OWNER
## Practice location
- **Address:** 3760 US HIGHWAY 17 UNIT 11, Richmond Hill, GA 31324-3378
- **Phone:** (912) 910-3777 · **Fax:** (912) 292-0005
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Georgia, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Interventional Pain Management (1), Pain Management (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 17, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1134909542) · Data from the CMS NPPES public registry.