Individual provider Active NPI

Dominic Vincent Lastoria, RN

  • Registered Nurse
  • Mayfield HTS, OH
National Provider Identifier
1558030692
Registry record updated Sep 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN462051 Issued in OH
Practice address
1210 Genesee Ave
Mayfield HTS, OH 44124-1724
Phone
(216) 313-0716
NPI assigned
Sep 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN462051 OH Primary

Addresses

Primary practice location

1210 Genesee Ave
Mayfield HTS, OH 44124-1724

Mailing address

1210 Genesee Ave
Mayfield HTS, OH 44124-1724
Phone (216) 313-0716

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN462051OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1631318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631318400000",
    "number": "1558030692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 GENESEE AVE",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441241724",
            "telephone_number": "216-313-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 GENESEE AVE",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441241724",
            "telephone_number": "216-313-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTORIA",
        "first_name": "DOMINIC",
        "middle_name": "VINCENT",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-11",
        "last_updated": "2021-09-11",
        "certification_date": "2021-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN462051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2021; 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.