Active NPI
Richard Pantalone, MD
- Family Medicine Physician
- Miramar, FL
National Provider Identifier
1770521650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 053529
- Practice address
- 3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308 - Phone
- (877) 866-7123
- NPI assigned
- Jun 3, 2006
- Last updated
- Dec 15, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 053529 | CT | Primary |
| Surgery Physician | 208600000X | 46018 | WI |
Addresses
Primary practice location
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Mailing address
1090 Neipsic Rd
Glastonbury, CT 06033-2604
Phone (608) 234-7919
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34428200 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053529 | CT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1770521650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1090 NEIPSIC RD",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060332604",
"telephone_number": "608-234-7919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 SW 160TH AVE",
"address_2": "SUITE 250",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330276308",
"telephone_number": "877-866-7123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANTALONE",
"first_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "053529",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "46018",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34428200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
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- Panda Kitchen Cabinets and Vanities
- Emilio Pando, MD
- Yves Franzric Pangilinan, P.T.
- Jacqueline Sophia Panton, ARNP
- Paradise Medical Equipment
- Paradise Senior Center Inc
- Anthony J Parenti, M.D.
- Brenda Ann Parker-Parks, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.