Active NPI
Matthew Pastor, PA-C
- Physician Assistant
- New York, NY
National Provider Identifier
1508693268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 622 W 168TH St
New York, NY 10032-3720 - Phone
- (212) 305-2500
- NPI assigned
- Sep 17, 2024
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
622 W 168TH St
New York, NY 10032-3720
Mailing address
443 Laurel Oak Rd FL 2
Voorhees, NJ 08043-4419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20241210000165 | NY | Order and Referring Only - Physician Assistant | 2365978798 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032853 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1508693268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "443 LAUREL OAK RD FL 2",
"city": "VOORHEES",
"state": "NJ",
"postal_code": "080434419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTOR",
"first_name": "MATTHEW",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-17",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.