Kenneth Pacofsky, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G32580 Issued in CA

Practice address

557 Misty View Way
Nipomo, CA 93444-8872

Phone

(805) 895-8776

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Mineral King Radiological Medical Group, Inc

  dba VIP Specialists

  • Diagnostic Radiology Physician
  • Visalia, CA
  • NPI 1578505202
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1326180613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1736",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934481736",
            "telephone_number": "805-895-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 MISTY VIEW WAY",
            "city": "NIPOMO",
            "state": "CA",
            "postal_code": "934448872",
            "telephone_number": "805-895-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACOFSKY",
        "first_name": "KENNETH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G32580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romeo S Ortiz, MD
• Ostatnigrosh Williams Chiropractic Professional Corporation
• Pacific Central Coast Health Centers (Monarch Village Health Center)
• Pacific Central Coast Health Centers (Nipomo Health Center)
• Pacific Holistic Dental, Inc.
• Ben C Palmer, O.D.
• Papageorge Enterprises Inc (Nipomo Rexall)
• Teresa Louise Pardini, M.S.,LMFT
• Nathaniel Parker, DO
• Haylie Jenna Pennachio, B.S. PSYCHOLOGY

• Diagnostic Radiology Physician in Nipomo, CA
• Providers in Nipomo, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.