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PREMIER SPINE & PAIN CENTER PA
NPI 1679762876
Pain Medicine - Pain Medicine in Orange Park, FL

Active since October 24, 2007
1543 KINGSLEY AVE STE 3, ORANGE PARK, FL 32073(904) 264-0770(904) 264-0670 Get Directions Write a Review

NPPES record last updated: April 12, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Premier Spine & Pain Center Pa NPPES

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

PREMIER SPINE & PAIN CENTER PA (NPI 1679762876) is a healthcare organization registered as a pain medicine in Orange Park, Florida and active in the NPI registry since October 2007. The organization lists Ashraf G Andrawis, President, as its authorized official.

NPPES Registry Identity

NPI1679762876
Entity TypeOrganization
Primary Taxonomy208VP0000X
Legal Business NamePREMIER SPINE & PAIN CENTER PA
Location Address1543 KINGSLEY AVE STE 3Orange Park, FL 32073-4583
Mailing Address1543 Kingsley Ave Ste 3Orange Park, FL 32073-4583 · (904) 264-0770 · Fax (904) 264-0670
Phone(904) 264-0770
Fax(904) 264-0670
Organization SubpartNo
Authorized OfficialAshraf G AndrawisPresident · (904) 264-0770
Enumeration DateOctober 24, 2007
Last NPPES UpdateApril 12, 2013
✔ NPI 1679762876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0000X
Definition
Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
1543 KINGSLEY AVE STE 3, Orange Park, FL 32073
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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)

Premier Spine & Pain Center Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Premier Spine & Pain Center PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (8)

Ashraf Andrawis, MD
Interventional Pain Management
NPI 1568445666
1543 KINGSLEY AVE BLDG 3
Orange Park, FL 32073
(904) 264-0770
✔ PECOS✔ Accepts MedicareSame address
Vanessa Lefler
Nurse Practitioner
NPI 1295215531
1543 KINGSLEY AVE STE 3
Orange Park, FL 32073
(904) 315-6539
✔ PECOS✔ Accepts MedicareSame address
Fabienne Rene, ARNP
Nurse Practitioner
NPI 1184402752
1543 KINGSLEY AVE STE 3
Orange Park, FL 32073
(904) 264-0770
✔ PECOS✔ Accepts MedicareSame address
Casey Thomas, APRN
Nurse Practitioner
NPI 1144003716
1543 KINGSLEY AVE STE 3
Orange Park, FL 32073
(904) 904-2640
✔ PECOS✔ Accepts MedicareSame address
Sourial Sourial, D.O.
Pain Management
NPI 1205148376
9770 OLD BAYMEADOWS RD STE 141
Jacksonville, FL 32256
(904) 944-2124
✔ PECOS✔ Accepts Medicare11 mi
Luis Colon, ARNP
Nurse Practitioner
NPI 1699083279
9770 OLD BAYMEADOWS RD STE 141
Jacksonville, FL 32256
(904) 944-2124
✔ PECOS✔ Accepts Medicare11 mi
Huber Matos-Garsault, M.D.
Interventional Pain Management
NPI 1649217076
2570 ATLANTIC BLVD
Jacksonville, FL 32207
(904) 398-4860
✔ PECOS✔ Accepts Medicare11 mi
Alfredo Romero, M.D.
Pain Management
NPI 1003914953
1202 E SONTERRA BLVD STE 101
San Antonio, TX 78258
(210) 546-1410
✔ PECOS✔ Accepts Medicare1,006 mi

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 10D1090473

Premier Spine & Pain Center · Orange Park, FL
Expired · Oct 12, 2026
CLIA Number10D1090473
Laboratory TypePhysician Office
Certificate Effective DateOctober 13, 2024
Certificate Expiration DateOctober 12, 2026
Laboratory DirectorAshraf Andrawis MD
Laboratory Phone(904) 264-0770
Laboratory LocationPremier Spine & Pain Center1543 Kingsley Ave, Bldg 3, Orange Park, FL 32073
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Premier Spine & Pain Center PA's NPI number?

The NPI number for Premier Spine & Pain Center PA is 1679762876. It was assigned to this organization in the NPPES registry on October 24, 2007.

Where is Premier Spine & Pain Center PA located?

Premier Spine & Pain Center PA is located at 1543 Kingsley Ave Ste 3, Orange Park, FL 32073. The listed phone number is (904) 264-0770.

What is Premier Spine & Pain Center PA's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Is Premier Spine & Pain Center PA enrolled in Medicare?

Yes. Premier Spine & Pain Center PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Premier Spine & Pain Center PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Premier Spine & Pain Center PA. 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. The largest specialties are Nurse Practitioner (4), Interventional Pain Management (2) and Pain Management (2). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Premier Spine & Pain Center PA accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Premier Spine & Pain Center PA 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 Premier Spine & Pain Center PA was last updated on April 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.