MEDICARE: ADVANCED PAIN MANAGEMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207L00000X	Anesthesiology Physician
2	363L00000X	Nurse Practitioner
3	207XS0117X	Orthopaedic Surgery of the Spine Physician

General Provider Information

NPI Number	:	1568289874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PAIN MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	5205 CHAIRMANS CT STE 201A
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21703-2918
Country	:	US
Telephone Number	:	240-629-3939
Fax Number	:

Provider Business Practice Location Address
First Line	:	5205 CHAIRMANS CT STE 201B
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21703-2918
Country	:	US
Telephone Number	:	240-629-3920
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	JOANA GOMES
Credential	:
Telephone Number	:	240-629-3982

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	02/20/2026

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