Individual provider Active NPI

Anthony Sanchez Pastore, PT

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1922517390
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8774 Issued in SC
Practice address
200 Patewood Dr Ste C150
Greenville, SC 29615-6323
Phone
(864) 454-0904
NPI assigned
Sep 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8774 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste C150
Greenville, SC 29615-6323

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180815001787 NC Practitioner - Physical Therapist in Private Practice 8123384872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8774SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proaxis Therapy NC, LLC Physical Therapist CurrentSince Aug 1, 2018 Accepting new patients
Proaxis Therapy SC, LLC Physical Therapist Past Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

33202 Collection Ctr Dr
Chicago, IL 60693

303 Park St
Belmont, NC 28012
Phone (704) 826-9980

205 Sage Rd
Ste 203
Chapel Hill, NC 27514
Phone (919) 918-4171

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1922517390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE C150",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156323",
            "telephone_number": "864-454-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTORE",
        "first_name": "ANTHONY",
        "middle_name": "SANCHEZ",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "8774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.