Individual provider Active NPI

Kevin Lee Hastings Jr., DO

  • Pain Medicine Physician
  • Johnson City, NY
National Provider Identifier
1639279748
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
200637 Issued in NY
Practice address
153 Oakdale Rd
Johnson City, NY 13790-1007
Phone
(607) 748-9001
Fax
(607) 748-8546
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 200637 NY Primary

Addresses

Primary practice location

153 Oakdale Rd
Johnson City, NY 13790-1007

Mailing address

153 Oakdale Rd
Johnson City, NY 13790-1007
Phone (607) 748-9001

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
I20080303000451 NY Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 8820172638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Osteopathic Manipulative Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

153 Oakdale Rd
Johnson City, NY 13790-1007
Phone (607) 748-9001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osteopathic Pain Management Services LLC Pain Medicine CurrentSince Dec 9, 2002 Accepting new patients

Locations

153 Oakdale Rd
Johnson City, NY 13790
Phone (607) 748-9001

200 Front St
Ste A
Vestal, NY 13850
Phone (607) 748-9001

Interoperability endpoints

  • Direct secure messaging: drhastings@osteopathicpain.medentdirect.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1639279748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 OAKDALE RD",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901007",
            "telephone_number": "607-748-9001",
            "fax_number": "607-748-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 OAKDALE RD",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901007",
            "telephone_number": "607-748-9001",
            "fax_number": "607-748-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASTINGS",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "200637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.