Individual provider Active NPI

Peter Pastuszko, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • New York, NY
National Provider Identifier
1194793448
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2013006648 Issued in MO
Practice address
1184 5TH Ave
New York, NY 10029-6503
Phone
(212) 241-3814
NPI assigned
Mar 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2013006648 MO Primary

Addresses

Primary practice location

1184 5TH Ave
New York, NY 10029-6503

Mailing address

1184 5TH Avenue
Box 1028
New York, NY 10029-4619
Phone (212) 241-3814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170328002196 NY Practitioner - Vascular SurgeryPractitioner - Thoracic Surgery 6002886926 Reassigns benefits to 1 organization
I20250530000197 MO Practitioner - Cardiac Surgery 6002886926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013006648MOMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince May 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince May 1, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 1, 2017 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients
Children'S Specialists of San Diego, Inc. (CSSD) Past Accepting new patients

Locations

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1184 5th Ave
New York, NY 10029
Phone (212) 241-7500

1184 5th Ave
#1028
New York, NY 10029

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1190 5th Ave
#2W
New York, NY 10029
Phone (212) 241-5646

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1194793448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 5TH AVENUE",
            "address_2": "BOX 1028",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294619",
            "telephone_number": "212-241-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-241-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTUSZKO",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2013006648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.