Individual provider Active NPI

Wilmar Giovanni Pantoja, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1619328325
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
301033 Issued in NY
Practice address
5 E 98TH St
New York, NY 10029-6501
Phone
(212) 241-6321
NPI assigned
Jun 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 301033 NY Primary

Addresses

Primary practice location

5 E 98TH St
New York, NY 10029-6501

Mailing address

PO Box 29207
San Juan, PR 00929-0207
Phone (787) 757-1800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191105001560 NY Practitioner - Emergency Medicine 6103158506 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Sep 22, 2019 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Sep 22, 2019 Accepting new patients
Fpa Hospital Based Current Accepting new patients

Locations

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1619328325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29207",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009290207",
            "telephone_number": "787-757-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOJA",
        "first_name": "WILMAR",
        "middle_name": "GIOVANNI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "301033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.