Individual provider Active NPI

Paolo S Pastore, MD

  • Family Medicine Physician
  • Cicero, NY
National Provider Identifier
1174502850
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
226948 Issued in NY
Practice address
8393 Elta Drive
Cicero, NY 13039
Phone
(315) 698-0290
Fax
(315) 698-0291
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 226948 NY Primary

Addresses

Primary practice location

8393 Elta Drive
Cicero, NY 13039

Mailing address

1001 W Fayette St
Ste 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000739 NY Practitioner - Family Practice 1557306057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Practice addresses (Care Compare)

1001 W Fayette St
Suite 400
Syracuse, NY 13204-2866
Phone (315) 472-1488

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

8393 Elta Dr
Cicero, NY 13039-8958
Phone (315) 698-0290

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Medical Group, PC Family Medicine CurrentSince Jul 1, 2005 Accepting new patients
Your Health Your Choice Dietetics and Nutrition PLLC Past Accepting new patients

Locations

8393 Elta Dr
Cicero, NY 13039
Phone (315) 698-0290

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

792 N Main St
Ste 200A
Syracuse, NY 13212
Phone (315) 458-8700

Interoperability endpoints

  • Direct secure messaging: ppastore@fcmg.medentdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1174502850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-472-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8393 ELTA DRIVE",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "13039",
            "telephone_number": "315-698-0290",
            "fax_number": "315-698-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTORE",
        "first_name": "PAOLO",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "226948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

Verify at the official NPI Registry.