Request an Appointment Share a few details about your visit, and the Manhattan Pain Medicine team will contact you to schedule an appointment. Are you a new or existing patient?* NEW PATIENTEXISTING PATIENT Name* First NameLast Name Email* example@example.com Date of Birth* /Month /DayYearDate Phone Number* Please enter a valid phone number. Consent to receive text messages By checking the box, I agree to be contacted via text message. By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from Manhattan Pain Medicine, PLLC. This includes SMS messages for appointment scheduling, reminders, post-visit instructions, and billing notifications. Message frequency varies. Message and data rates may apply. See privacy policy at https://www.manhattanpainmedicine.com/privacy-policy/. Message HELP for assistance at 646-580-3538. Reply STOP to any message to opt out. Please tell us the reason for your visit: Which provider would you like to see? Jason W. Siefferman, MD - INTERVENTIONAL PAIN MANAGEMENT, HEADACHENino Mikaberidze, MD - RHEUMATOLOGY & INTERNAL MEDICINELuis Aranguren, MD - INTERVENTIONAL PAIN MANAGEMENTLuke Kane, DO, RMSK, CAc - PHYSICAL MEDICINE & REHABILITATION, REGENERATIVE MEDICINETayyaba Ahmed, DO - PHYSICAL MEDICINE & REHABILITATION, PELVIC PAINAdam Rosenberg, PA-C - PHYSICIAN ASSISTANTJordan Shankle, PA-C - PHYSICIAN ASSISTANTDeborah Barbiere, Psy.D., L.Ac. - PAIN PSYCHOLOGYKira Charles - CERTIFIED FELDENKRAIS, PRACTITIONER Who referred you to us? Please upload clear images of the front and back of your insurance card, as well as your ID card: Browse FilesDrag and drop files here Choose a file Cancelof If you would like to schedule an appointment regardless of your insurance (self-pay), click here. Has your insurance changed since your last visit?* YESNO Please request an appointment through the Manhattan Pain Medicine patient portal, or call us directly at (646) 580-3538. Thank you. Do you know the details of your new insurance? YESNO Please provide the information or upload a copy of your insurance card below: Please upload clear images of the front and back of your insurance card, as well as your ID card: Browse FilesDrag and drop files here Choose a file Cancelof thg_4978f9 thg_4978f9_ts thg_1985e1 thg_1985e1_ts thg_ddb779 thg_ddb779_ts thg_f94173 thg_f94173_ts thg_4447b2_c thg_4447b2_m thg_4447b2_s thg_4447b2_ts thg_4f25b4 Submit Should be Empty: