COMMONWEALTH PAIN ASSOCIATES, PLLC

Provider Demographics

• NPI: 1306280177
• Name: COMMONWEALTH PAIN ASSOCIATES, PLLC
• Entity type: Organization
• Organization Name: COMMONWEALTH PAIN ASSOCIATES, PLLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - Prefix: DR
• Authorized Official - First Name: JASON
• Authorized Official - Last Name: LEWIS
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 502-855-7200
• Mailing Address - Street 1: PO BOX 21890
• Mailing Address - City: BELFAST
• Mailing Address - State: ME
• Mailing Address - Zip Code: 04915-4115
• Mailing Address - Country: US
• Mailing Address - Phone: 502-907-0356
• Mailing Address - Fax: 502-919-9780
• Practice Address - Street 1: 120 EXECUTIVE PARK
• Practice Address - City: LOUISVILLE
• Practice Address - State: KY
• Practice Address - Zip Code: 40207
• Practice Address - Country: US
• Practice Address - Phone: 502-855-7200
• Practice Address - Fax: 502-855-7201
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2013-04-24
• Last Update Date: 2025-08-28

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	208VP0014X	Allopathic & Osteopathic Physicians	Pain Medicine	Interventional Pain Medicine	Group - Single Specialty
No	207LP2900X	Allopathic & Osteopathic Physicians	Anesthesiology	Pain Medicine	Group - Multi-Specialty
No	207L00000X	Allopathic & Osteopathic Physicians	Anesthesiology		Group - Multi-Specialty
No	208VP0000X	Allopathic & Osteopathic Physicians	Pain Medicine	Pain Medicine	Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363AM0700X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Medical	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	363LA2200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Adult Health	Group - Multi-Specialty
No	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty
No	367500000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Anesthetist, Certified Registered		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IL	1306280177	Medicaid
IN	300012363	Medicaid
IN	300014938	Medicaid
IN	300026415	Medicaid
KY	7100318140	Medicaid
IN	201287400C	Medicaid
IN	300050981	Medicaid
KY	7100607850	Medicaid
IN	300027005	Medicaid
IN	300073973	Medicaid
IN	201287400E	Medicaid
TN	Q091113	Medicaid
OH	0300626	Medicaid
IN	300009547	Medicaid
IN	300061140	Medicaid
IN	201287400A	Medicaid
IN	201287400B	Medicaid
IN	300014863	Medicaid
IN	300026044	Medicaid
KY	7100270310	Medicaid
KY	7100349390	Medicaid
KY	7100488260	Medicaid