Organization Active NPI

Raymond J. Pastore, M.D., P.C.

  • Hematology & Oncology Physician
  • Valley Stream, NY
National Provider Identifier
1477767663
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
103104 Issued in NY
Legal business name
RAYMOND J. PASTORE, M.D., P.C.
Practice address
282 N Corona Ave
Valley Stream, NY 11580-4127
Phone
(516) 872-0111
Fax
(516) 825-2415
NPI assigned
May 9, 2007
Last updated
Jun 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Dr. Raymond J. Pastore, M.D.NPI 1649363367
Title
President
Phone
(516) 872-0111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X 103104 NY Primary

Addresses

Primary practice location

282 N Corona Ave
Valley Stream, NY 11580-4127

Mailing address

282 N Corona Ave
Valley Stream, NY 11580-4127
Phone (516) 872-0111

Other identifiers 1

IdentifierTypeStateIssuer
001788890MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101014001108 NY Part B Supplier - Clinic/Group Practice 6103019799 Receives reassigned benefits from 1 practitioner
Practice locations: Valley Stream, NY; Far Rockaway, NY

National Provider Directory

National Provider Directory

Locations

282 N Corona Ave
Valley Stream, NY 11580
Phone (516) 872-0111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1477767663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 N CORONA AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804127",
            "telephone_number": "516-872-0111",
            "fax_number": "516-825-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 N CORONA AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804127",
            "telephone_number": "516-872-0111",
            "fax_number": "516-825-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND J. PASTORE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "PASTORE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-872-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "103104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001788890",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.