Salvatore Russell Pecoraro, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

183816 Issued in NY

Practice address

200 Ohio Street
Medina Memorial Hospital
Medina, NY 14103

Phone

(585) 798-8080

NPI assigned

Feb 22, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Internal Medicine at Lakeside

  • Internal Medicine Physician
  • Brockport, NY
  • NPI 1083939722
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548395429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 FORESTVIEW COURT",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211445",
            "telephone_number": "716-689-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OHIO STREET",
            "address_2": "MEDINA MEMORIAL HOSPITAL",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "14103",
            "telephone_number": "585-798-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECORARO",
        "first_name": "SALVATORE",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "183816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183816",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orleans Medical PC
• Orleans-Niagara Boces
• Orrnc Operating LLC (Orchard Rehabilitation & Nursing Center)
• Melody Ann Parker, LICENSED PRACTICE NU
• Paul R Grout (Medicine Shoppe)
• Frances Pierce, LPN
• Karen Elizabeth Polechetti, CRNA
• Tammy R Pollock, CD (CBI)
• Katrina J Potter
• Prescription Center of Medina, LLC (The Medicine Shoppe)

• Emergency Medicine Physician in Medina, NY
• Providers in Medina, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.