Individual provider Active NPI

Pasquale Moscato, PA

  • Medical Physician Assistant
  • Newburgh, NY
National Provider Identifier
1174628861
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003501 Issued in NY
Practice address
5109 Route 9W
Newburgh, NY 12550-1952
Phone
(845) 561-0002
NPI assigned
Sep 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003501 NY Primary

Addresses

Primary practice location

5109 Route 9W
Newburgh, NY 12550-1952

Mailing address

236 Crystal Run Rd
Suite 2
Middletown, NY 10941-4009
Phone (845) 692-3100

Other identifiers 1

IdentifierTypeStateIssuer
003501OtherNYLICENSE NUMBER

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060405000392 NY Practitioner - Physician Assistant 3173531944 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fishkill Pharmacy LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174628861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CRYSTAL RUN RD",
            "address_2": "SUITE 2",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414009",
            "telephone_number": "845-692-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 ROUTE 9W",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501952",
            "telephone_number": "845-561-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCATO",
        "first_name": "PASQUALE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "003501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "003501",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.