Pain Treatment Centers of Georgia LLC
NPI 1619702792ActiveOrganization· Clinic/Center· Savannah, GA
Clinic/Center in Savannah, Georgia, registered in NPPES in September 2024. The authorized official on file is Vadim Petrov-Kondratov, MD, Owner. Enrolled in Medicare as dme supplier - physician - interventional pain management.
Overview
| NPI | 1619702792 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 6, 2024 |
| Last updated in NPPES | Sep 6, 2024 |
| Certified by provider | Sep 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | — | — |
| Clinic/Center, Pain | 261QP3300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Interventional Pain Management (GA) |
|---|
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