Active NPI
Patrick Pasterick
- Home Health Registered Nurse
- Clarksburg, WV
National Provider Identifier
1417667387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Registered Nurse
- License
- 92660
- Practice address
- 2673 Davisson Run Rd
Clarksburg, WV 26301-6838 - Phone
- (681) 342-3200
- NPI assigned
- Dec 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 92660 | WV | Primary |
Addresses
Primary practice location
2673 Davisson Run Rd
Clarksburg, WV 26301-6838
Mailing address
2673 Davisson Run Rd
Clarksburg, WV 26301-6838
Phone (681) 342-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240216001474 | WV | Order and Referring Only - Nurse Practitioner | 6103260203 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92660 | WV | MD | Home Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1417667387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2673 DAVISSON RUN RD",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263016838",
"telephone_number": "681-342-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2673 DAVISSON RUN RD",
"city": "CLARKSBURG",
"state": "WV",
"postal_code": "263016838",
"telephone_number": "681-342-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTERICK",
"first_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-01",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "WV",
"license": "92660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.