Active NPI
Dominick a. Grosso, D.O. LLC
- Internal Medicine Physician
- Red Bank, NJ
National Provider Identifier
1063436749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 25MB04501200
- Legal business name
- DOMINICK A. GROSSO, D.O. LLC
- Practice address
- 5 Globe CT
Red Bank, NJ 07701-1824 - Phone
- (732) 219-0110
- Fax
- (732) 212-8818
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dominick A. Grosso, D.O.
- Title
- Physician/Owner
- Phone
- (732) 219-0110
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 25MB04501200 | NJ | |
| Internal Medicine Physician | 207R00000X | 25MB04501200 | NJ | Primary |
Addresses
Primary practice location
5 Globe CT
Red Bank, NJ 07701-1824
Mailing address
5 Globe CT
Red Bank, NJ 07701-1824
Phone (732) 219-0110
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2599954 | Other | NJ | GHI |
| 1485601 | Medicaid | NJ |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187740800000",
"number": "1063436749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 GLOBE CT",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077011824",
"telephone_number": "732-219-0110",
"fax_number": "732-212-8818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 GLOBE CT",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077011824",
"telephone_number": "732-219-0110",
"fax_number": "732-212-8818"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DOMINICK A. GROSSO, D.O. LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-27",
"last_updated": "2007-08-22",
"status": "A",
"authorized_official_last_name": "GROSSO",
"authorized_official_first_name": "DOMINICK",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "732-219-0110",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": "NJ",
"license": "25MB04501200",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MB04501200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "2599954",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1485601",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Bank, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.