PAIN MANAGEMENT & REHABILITATION MEDICINE CENTER PC

NPI: 1295760916 · MESA, AZ 85203 · Vascular & Interventional Radiology Physician · NPI assigned 07/11/2006

$17K

Total Medicaid Paid

Total Claims

Beneficiaries

Codes Billed

2018-10

First Month

2018-12

Last Month

Provider Details

Authorized Official	GAMPEL, YURY (OWNER)
NPI Enumeration Date	07/11/2006

Other providers sharing the same authorized official: GAMPEL, YURY

Provider	City	State	Total Paid
MODERN VASCULAR OF GLENDALE, LLC	GLENDALE	AZ	$780K
MODERN VASCULAR - NAVAJO LLC	ALBUQUERQUE	NM	$248K
MODERN VASCULAR OF SOUTHAVEN, LLC	SOUTHAVEN	MS	$85K
MODERN VASCULAR OF DENVER, LLC	THORNTON	CO	$44K
MODERN VASCULAR OF ST LOUIS LLC	CREVE COEUR	MO	$17K
SAN ANTONIO VASCULAR SPECIALISTS CORP	SAN ANTONIO	TX	$8K
MODERN VASCULAR OF SUN CITY, LLC	SURPRISE	AZ	$5K
MODERN VASCULAR OF TUCSON, LLC	TUCSON	AZ	$4K
INDIANAPOLIS VASCULAR SPECIALISTS CORP	INDIANAPOLIS	IN	$282.71

Year	Claims	Total Paid
2018	57	$17K

Code	Description	Claims	Beneficiaries	Total Paid
37252		15	13	$14K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	27	26	$2K
75710		15	13	$1K