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Physician Compare National (NPI:1720025711)

HEALTHCARE PROVIDER: DOMINIC JAMES PASTORE O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1720025711
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 7719170026
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20101019001231
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name PASTORE
Individual professional last name
Provider First Name DOMINIC
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2002
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name PASTORE-TRAN EYECARE, INC.
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 6103897277
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1000 N WICKHAM RD
Group Practice or individual's line 1 address
City MELBOURNE
Group Practice or individual's city
State FL
Group Practice or individual's state
Zip Code 329358937
Group Practice or individual's zip code (9 digits when available)
Phone Number 3212591699
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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