Individual provider Active NPI

Michael Vito Fornataro, RPH

  • Pharmacist
  • New Castle, PA
National Provider Identifier
1295873750
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP036614L Issued in PA
Practice address
708 E Washington St
New Castle, PA 16101-4137
Phone
(724) 658-4557
Fax
(724) 658-4547
NPI assigned
Feb 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP036614L PA Primary

Addresses

Primary practice location

708 E Washington St
New Castle, PA 16101-4137

Mailing address

708 E Washington St
New Castle, PA 16101-4137
Phone (724) 658-4557

Other identifiers 2

IdentifierTypeStateIssuer
3937476OtherPANABP
0019495420001MedicaidPA

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RP036614LPAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mikes Apothecary Inc Past Accepting new patients

Organizations & group practices 1

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": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1295873750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 E WASHINGTON ST",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161014137",
            "telephone_number": "724-658-4557",
            "fax_number": "724-658-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 E WASHINGTON ST",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161014137",
            "telephone_number": "724-658-4557",
            "fax_number": "724-658-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNATARO",
        "first_name": "MICHAEL",
        "middle_name": "VITO",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-04",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP036614L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3937476",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019495420001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.