GREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC
NPI 1629447719
Physical Medicine & Rehabilitation - Pain Medicine in Flint, MI
About Great Lakes Interventional Pain Management,pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT LAKES INTERVENTIONAL PAIN MANAGEMENT,PLLC (NPI 1629447719) is a healthcare organization registered as a pain medicine in Flint, Michigan and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through June 12, 2027 and lists Kavitha Rukkannagari Reddy, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Great Lakes Interventional Pain Management,pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Great Lakes Interventional Pain Management,pllc, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Waiver 23D2015468
Great Lakes Interventional Pain Management PLLC · Flint, MIFrequently 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 Great Lakes Interventional Pain Management,pllc's NPI number?
The NPI number for Great Lakes Interventional Pain Management,pllc is 1629447719. It was assigned to this organization in the NPPES registry on September 18, 2015.
Where is Great Lakes Interventional Pain Management,pllc located?
Great Lakes Interventional Pain Management,pllc is located at 1311 S Linden Rd Suite A, Flint, MI 48532. The listed phone number is (810) 230-1210.
What is Great Lakes Interventional Pain Management,pllc's specialty?
The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.
Is Great Lakes Interventional Pain Management,pllc enrolled in Medicare?
Yes. Great Lakes Interventional Pain Management,pllc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Great Lakes Interventional Pain Management,pllc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Medicine and Rehabilitation) reassigns their Medicare billing to Great Lakes Interventional Pain Management,pllc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Great Lakes Interventional Pain Management,pllc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D2015468) is associated with this NPI, valid through June 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Great Lakes Interventional Pain Management,pllc accept?
Health plans from Blue Care Network of Michigan list Great Lakes Interventional Pain Management,pllc 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 Great Lakes Interventional Pain Management,pllc was last updated on November 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Great Lakes Interventional Pain Management,pllc · NPI 1629447719
Pain Medicine organization in Flint, Michigan. Organization record, active in the CMS NPPES registry since September 18, 2015.
## Identity
- **NPI:** 1629447719 (Entity type: Organization)
- **Enumerated:** September 18, 2015
- **Primary specialty:** Physical Medicine & Rehabilitation - Pain Medicine · taxonomy 2081P2900X
- **Organization subpart:** No
- **Authorized official:** Kavitha Reddy, PHYSICIAN
## Practice location
- **Address:** 1311 S LINDEN RD, SUITE A, Flint, MI 48532-3428
- **Phone:** (810) 230-1210 · **Fax:** (810) 230-1225
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Physical Medicine and Rehabilitation) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 17, 2016
- **Other identifiers:** Medicare UPIN 5315020738 (MI); Other 1174515084 (MI); Medicaid 5353030 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1629447719) · Data from the CMS NPPES public registry.