Individual provider Active NPI

Michele Marie Pusateri

  • Pharmacist
  • Clarks Summit, PA
National Provider Identifier
1053889253
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP037273L Issued in PA
Practice address
11 Woodridge Cir
Clarks Summit, PA 18411-2039
Phone
(570) 586-4039
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP037273L PA Primary

Addresses

Primary practice location

11 Woodridge Cir
Clarks Summit, PA 18411-2039

Mailing address

617 3Rd St
Dunmore, PA 18512-2849
Phone (570) 209-7440

Other identifiers 1

IdentifierTypeStateIssuer
RP037273LOtherPAPHARMACY LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RP037273LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Depietros Pharmacy LLC Past Accepting new patients
Depietros Pharmacy LLC PastSince Sep 15, 2019 Accepting new patients

Organizations & group practices 2

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": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1053889253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 3RD ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185122849",
            "telephone_number": "570-209-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WOODRIDGE CIR",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112039",
            "telephone_number": "570-586-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUSATERI",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP037273L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "RP037273L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.