PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
NPI 1265435416
Specialist in San Luis Obispo, CA

NPI Status: Active since May 23, 2005

Contact Information

10 SANTA ROSA ST
STE 201
SAN LUIS OBISPO, CA
ZIP 93405
Phone: (805) 782-8132
Fax: (805) 597-8350

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  • Organization
  • Specialist
  • CLIA Number: 05D1087052
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-08-2027

About PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP

This page provides the complete NPI Profile along with additional information for Pain Management Specialists Medical Group, a provider established in San Luis Obispo, California operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1265435416 assigned on May 2005. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 16 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 former legal business name is Interventional Pain Management. The authorized official of this NPI record is Ms. Inna Gribanova (Manager)

NPI
1265435416
Provider Legal Name
PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
Other Organization Name
INTERVENTIONAL PAIN MANAGEMENT
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
10 SANTA ROSA ST STE 201 SAN LUIS OBISPO, CA 93405
Location Phone
(805) 782-8132
Location Fax
(805) 597-8350
Mailing Address
PO BOX 4659 SAN LUIS OBISPO, CA 93403
Mailing Phone
(805) 782-8132
Mailing Fax
(805) 597-8350
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-23-2005
Last Update Date
12-29-2010
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
Taxonomy Description
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.

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

MS. INNA GRIBANOVA

Authorized Official Title
MANAGER
Authorized Official Phone
(805) 782-8132

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
GR0105740MEDICAID (05)CA 
W18564MEDICARE PIN (08)CA 

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
05D1087052
Facility Type
Physician Office
Certificate Effective Date
March 09, 2025
Certificate Expiration Date
March 08, 2027
Laboratory Director
BORIS I. PILCH
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Pain Management Specialists Medical Group 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 1265435416, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

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
6
Doubled → 12 → 1 + 2
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
4
Unchanged
Pos 9
1
Doubled → 2
Check
6
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 6 → 12 → 3 4 → 8 5 → 10 → 1 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 2 + 1 + 2 + 5 + 8 + 3 + 1 + 0 + 4 + 2 + 24 = 54

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

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1265435416.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
Specialist
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
Specialist
10 SANTA ROSA ST, SUITE 201
SAN LUIS OBISPO, CA 93405
Nurse Anesthetist, Certified Registered
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
Nurse Practitioner (Family)
10 SANTA ROSA ST, STE 201
SAN LUIS OBISPO, CA 93405
Physician Assistant (Medical)
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
Physical Medicine & Rehabilitation (Pain Medicine)
10 SANTA ROSA ST, STE, 201
SAN LUIS OBISPO, CA 93405
Anesthesiology (Pain Medicine)
10 SANTA ROSA ST, STE-101
SAN LUIS OBISPO, CA 93405
Nurse Practitioner (Family)
10 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
Pain Medicine (Interventional Pain Medicine)
10 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265435416, enumerated as an "organization" on May 23, 2005.

The provider is located at 10 SANTA ROSA ST STE 201 SAN LUIS OBISPO, CA 93405 and the phone number is (805) 782-8132.

Specialist with taxonomy code 174400000X.

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