Physician Compare National (NPI:1992905814)

HEALTHCARE PROVIDER: JOSEPH STANLEY RESTIVO DO

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

Individual Professional Information
NPI	1992905814
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0143465500
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181203003404
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RESTIVO
	Individual professional last name
Provider First Name	JOSEPH
	Individual professional first name
Provider Middle Name	S A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KANSAS CITY UNIVERSITY OF PHYSICIANS AND SURGEONS
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	PATHOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	IRL PATHOLOGY SERVICES MIDAMERICA LLC
	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	0840558664
	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	15
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5721 W 119TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	FORWARD PATH SOLTNS
	Group Practice or individual's line 2 address
City	OVERLAND PARK
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	662093722
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9134986167
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260027
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RESEARCH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260190
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LEE'S SUMMIT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	260214
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BELTON REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y