NPIMap

Organization Active NPI

Endocrinology and Infectious

  • Endocrinology, Diabetes & Metabolism Physician
  • Sterling, VA
National Provider Identifier
1609074459
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0101057623 Issued in VA
Legal business name
ENDOCRINOLOGY AND INFECTIOUS
Practice address
21475 Ridgetop Cir Ste 350
Sterling, VA 20166-6580
Phone
(703) 430-6211
Fax
(703) 430-1414
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Authorized official

Name
Dr. Antonio Pastor, M.D.NPI 1912120056
Title
President
Phone
(703) 430-6211

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 0101057623 VA Primary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X 0101053112 VA

Addresses

Primary practice location

21475 Ridgetop Cir Ste 350
Sterling, VA 20166-6580

Mailing address

6035 Burke Centre Pkwy
Burke, VA 22015-3750
Phone (703) 978-1196

Other identifiers 1

IdentifierTypeStateIssuer
CK5247OtherMEDICARE, RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050203000075 DC Part B Supplier - Clinic/Group Practice 7416908850 Receives reassigned benefits from 1 practitioner
Practice locations: Falls Church, VA; Reston, VA; Fairfax, VA
O20080908000541 VA Part B Supplier - Clinic/Group Practice 7416908850 Receives reassigned benefits from 2 practitioners
Practice locations: Sterling, VA

National Provider Directory

National Provider Directory

Locations

6035 Burke Centre Pkwy
Burke, VA 22015
Phone (703) 425-4435

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1609074459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 BURKE CENTRE PKWY",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153750",
            "telephone_number": "703-978-1196",
            "fax_number": "703-978-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21475 RIDGETOP CIR STE 350",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201666580",
            "telephone_number": "703-430-6211",
            "fax_number": "703-430-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY AND INFECTIOUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "PASTOR",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-430-6211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "VA",
            "license": "0101057623",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "VA",
            "license": "0101053112",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, RAILROAD",
            "identifier": "CK5247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.