Active NPI
Richard Joseph Fastiggi, MD
- Gastroenterology Physician
- Corning, NY
National Provider Identifier
1053387613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 171866-1
- Practice address
- 130 Center Way
Corning, NY 14830-2255 - Phone
- (607) 936-9971
- Fax
- (607) 936-2600
- NPI assigned
- Feb 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MD040004E | PA | |
| Gastroenterology Physician | 207RG0100X | 171866-1 | NY | Primary |
Addresses
Primary practice location
130 Center Way
Corning, NY 14830-2255
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GU039871 | Other | PA | MEDICARE GROUP |
| 001097790002 | Medicaid | PA | |
| CC8362 | Other | NY | RR MEDICARE GROUP |
| 01035905 | Medicaid | NY | |
| 110209180 | Other | PA | RR MEDICARE PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171866-1 | NY | MD | Gastroenterology Physician |
| MD040004E | PA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group, P.C. | Gastroenterology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311897600000",
"number": "1053387613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 GUTHRIE SQ",
"city": "SAYRE",
"state": "PA",
"postal_code": "188401625",
"telephone_number": "570-888-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 CENTER WAY",
"city": "CORNING",
"state": "NY",
"postal_code": "148302255",
"telephone_number": "607-936-9971",
"fax_number": "607-936-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASTIGGI",
"first_name": "RICHARD",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-24",
"last_updated": "2011-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "PA",
"license": "MD040004E",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "171866-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "GU039871",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001097790002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CC8362",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01035905",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "110209180",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Corning, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.