Individual provider Active NPI

Constance Pasternak, NP

  • Adult Health Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1396892501
Registry record updated Jun 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5005141 Issued in NC
Practice address
3803 N Elm St
Greensboro, NC 27455-2593
Phone
(828) 450-0528
Fax
(336) 540-6156
NPI assigned
Jan 3, 2007
Last updated
Jun 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2011

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 303539 NY
Adult Health Nurse Practitioner 363LA2200X 5005141 NC Primary
Gerontology Nurse Practitioner 363LG0600X 340560 NY
Registered Nurse 163W00000X 478896-1 NY
Registered Nurse 163W00000X 244672 NC

Addresses

Primary practice location

3803 N Elm St
Greensboro, NC 27455-2593

Mailing address

9 Homewood Dr
Asheville, NC 28803-1242
Phone (828) 450-0528

Other identifiers 1

IdentifierTypeStateIssuer
02353657MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
244672NCMDRegistered Nurse
478896-1NYMDRegistered Nurse
303539NYMDAdult Health Nurse Practitioner
340560NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Group of Western New York, LLP PastSince Jul 1, 1993 Accepting new patients
Mobile Nurse Practitioners Gerontology Past Accepting new patients
Mobile Nurse Practitioners Past Accepting new patients
Rpci Oncology PC Past Accepting new patients

Organizations & group practices 4

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1396892501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HOMEWOOD DR",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288031242",
            "telephone_number": "828-450-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552593",
            "telephone_number": "828-450-0528",
            "fax_number": "336-540-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTERNAK",
        "first_name": "CONSTANCE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "303539",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5005141",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340560",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "478896-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "244672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02353657",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.