Katherine Ines Passaro

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02760801 Issued in NJ

Practice address

475 Seaview Ave
Staten Island, NY 10305-3436

Phone

(917) 412-7900

NPI assigned

Apr 15, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1245727312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 TODT HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145529",
            "telephone_number": "917-412-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "917-412-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSARO",
        "first_name": "KATHERINE",
        "middle_name": "INES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02760801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole M Pasquale, LMSW
• Valentina Marie Pasquale
• Kathleen Pasquali, SEIT
• Dawn Marie Pasqualucci
• Nicole M Passanante, PA
• Karen Passburg
• Michael Pastena
• Peter Coronel Pastolero, M.D.
• Ayesha I Patabendi Koralalage, LPN
• Anju M Patel, PA

• General Practice Dentistry in Staten Island, NY
• Providers in Staten Island, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.