Individual provider Active NPI

Domenico S Ausiello, MD

  • Family Medicine Physician
  • Greenville, MI
National Provider Identifier
1144254095
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301053623 Issued in MI
Practice address
200 S Franklin St
Greenville, MI 48838-1740
Phone
(616) 754-6949
Fax
(616) 754-1062
NPI assigned
Jul 10, 2006
Last updated
Dec 16, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301053623 MI Primary

Addresses

Primary practice location

200 S Franklin St
Greenville, MI 48838-1740

Mailing address

200 S Franklin St
Greenville, MI 48838-1740
Phone (616) 754-6949

Other identifiers 1

IdentifierTypeStateIssuer
2751016MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104001307 MI Practitioner - Family PracticePractitioner - Geriatric Medicine 7618950221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

200 S Franklin St
Greenville, MI 48838-1740
Phone (616) 754-6949

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Domenico S Ausiello MD PC Family Medicine CurrentSince Apr 6, 2011 Accepting new patients
Newaygo County General Hospital Association Past Accepting new patients
Newaygo County General Hospital Association Past Accepting new patients

Locations

200 S Franklin St
Greenville, MI 48838
Phone (616) 754-6949

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1144254095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S FRANKLIN ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488381740",
            "telephone_number": "616-754-6949",
            "fax_number": "616-754-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S FRANKLIN ST",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488381740",
            "telephone_number": "616-754-6949",
            "fax_number": "616-754-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSIELLO",
        "first_name": "DOMENICO",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301053623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2751016",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

Verify at the official NPI Registry.