Pca Interventional Spine at Fayette, LLC
NPI 1447791074 · Pain Clinic/Center · Fayetteville, GA
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pca Interventional Spine at Fayette, LLC is a Pain Clinic/Center organization in Fayetteville, GA (NPI 1447791074).
Provider details
- NPI number
- 1447791074
- Entity type
- Organization
- Primary specialty
- Pain Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Rodrigo Duralde, Owner(404) 351-7654
- License
- IN PROCESS (GA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
9 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,114 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Injection of Anesthetic And/Or Steroid Drug Into Sacral Spine Nerve Root Using Imaging Guidance, Single Level64483 | 366 | $386 |
| Injection Procedure for Sacroiliac Joint; Provision of Anesthetic, Steroid And/Or Other Therapeutic Agent, With Or Without ArthrographyG0260 | 278 | $280 |
| Injection of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Level64493 | 181 | $364 |
| Destruction of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance, Single Facet Joint64635 | 150 | $703 |
| Injection of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance62321 | 42 | $354 |
| Injection of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Level |
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-03-15
- Last updated
- 2026-02-20
- Certified
- 2026-02-20
Frequently asked questions
- What is Pca Interventional Spine at Fayette, LLC's NPI number?
- Pca Interventional Spine at Fayette, LLC's National Provider Identifier (NPI) is 1447791074, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pca Interventional Spine at Fayette, LLC?
- Pca Interventional Spine at Fayette, LLC is classified in the NPPES registry as Pain Clinic/Center (Ambulatory Health Care Facilities).
- Where is Pca Interventional Spine at Fayette, LLC located?
- Pca Interventional Spine at Fayette, LLC's practice location on file with NPPES is 1233 Highway 54 W, Fayetteville, GA 30214-4542.
- What is Pca Interventional Spine at Fayette, LLC's phone number?
- The practice phone number listed in the NPPES registry for Pca Interventional Spine at Fayette, LLC is (404) 351-7654.
- Does Pca Interventional Spine at Fayette, LLC accept Medicare?
- Pca Interventional Spine at Fayette, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pca Interventional Spine at Fayette, LLC?
- The authorized official listed on Pca Interventional Spine at Fayette, LLC's NPPES record is Rodrigo Duralde, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pca Interventional Spine at Fayette, LLC's NPI active?
- Yes — Pca Interventional Spine at Fayette, LLC's NPI (1447791074) is active in the NPPES registry as of the last update on 2026-02-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.