Individual provider Active NPI

Dominick J Pastore, M.D.

  • Pediatrics Physician
  • Richmond, VA
National Provider Identifier
1386607778
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101048164 Issued in VA
Practice address
1001 Hioaks Rd
Richmond, VA 23225-4029
Phone
(804) 320-7139
Fax
(804) 323-0153
NPI assigned
Apr 8, 2006
Last updated
Nov 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 048164 VA
Pediatrics Physician 208000000X 0101048164 VA Primary

Addresses

Primary practice location

1001 Hioaks Rd
Richmond, VA 23225-4029

Mailing address

1001 Hioaks Rd
Richmond, VA 23225-4029
Phone (804) 320-7139

Other identifiers 1

IdentifierTypeStateIssuer
006707912MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170203001079 VA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9830371616

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048164VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates PC Specialist 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, 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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1386607778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 HIOAKS RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254029",
            "telephone_number": "804-320-7139",
            "fax_number": "804-323-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HIOAKS RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254029",
            "telephone_number": "804-320-7139",
            "fax_number": "804-323-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTORE",
        "first_name": "DOMINICK",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "048164",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101048164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006707912",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.