ADVANCED PAIN MANAGEMENT CLINIC, INC
NPI 1255565388
Anesthesiology - Pain Medicine in Jacksonville, FL

NPI Status: Active since May 04, 2009

Contact Information

5757 BOOTH RD
BUILDING 100
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 683-2596
Fax: (904) 683-2597

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  • Organization
  • Anesthesiology
  • Pain Medicine
  • CLIA Number: 10D1107226
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-23-2026

About ADVANCED PAIN MANAGEMENT CLINIC, INC

This page provides the complete NPI Profile along with additional information for Advanced Pain Management Clinic, Inc, a provider established in Jacksonville, Florida operating as a Anesthesiology, focusing in pain medicine . The healthcare provider is registered in the NPI registry with number 1255565388 assigned on May 2009. The practitioner's primary taxonomy code is 207LP2900X with license number OS8432 (FL). The provider is registered as an organization and their NPI record was last updated 14 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 authorized official of this NPI record is Dr. Michael Scott Willens D.o. (President)

NPI
1255565388
Provider Name
ADVANCED PAIN MANAGEMENT CLINIC, INC
Entity Type
Organization
Location Address
5757 BOOTH RD BUILDING 100 JACKSONVILLE, FL 32207
Location Phone
(904) 683-2596
Location Fax
(904) 683-2597
Mailing Address
5757 BOOTH RD BUILDING 100 JACKSONVILLE, FL 32207
Mailing Phone
(904) 683-2596
Mailing Fax
(904) 683-2597
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-04-2009
Last Update Date
10-01-2012
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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

Anesthesiology Pain Medicine

Taxonomy Code
207LP2900X
Type
Allopathic & Osteopathic Physicians
License No.
OS8432
License State
FL
Taxonomy Description
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. MICHAEL SCOTT WILLENS D.O.

Authorized Official Title
PRESIDENT
Authorized Official Phone
(904) 635-5555

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
H46915MEDICARE UPIN (02)FL 

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
10D1107226
Facility Type
Physician Office
Certificate Effective Date
August 24, 2024
Certificate Expiration Date
August 23, 2026
Laboratory Director
RICKY BATEH
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Advanced Pain Management Clinic, Inc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha 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 1255565388, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

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.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
8
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 5 → 10 → 1 5 → 10 → 1 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 0 + 5 + 1 + 0 + 6 + 1 + 0 + 3 + 1 + 6 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1255565388.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dermatology
5757 BOOTH RD, #200
JACKSONVILLE, FL 32207
Internal Medicine
5757 BOOTH RD, SUITE 200
JACKSONVILLE, FL 32207

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255565388, enumerated as an "organization" on May 04, 2009.

The provider is located at 5757 BOOTH RD BUILDING 100 JACKSONVILLE, FL 32207 and the phone number is (904) 683-2596.

Anesthesiology with taxonomy code 207LP2900X and a focus in Pain Medicine.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.