Individual provider Active NPI

Scott Michael Kroczolowski

  • Pharmacist
  • Rochester Hills, MI
National Provider Identifier
1205948957
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032057 Issued in MI
Practice address
1701 South Blvd E Ste 105
Rochester Hills, MI 48307-6121
Phone
(248) 852-9355
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032057 MI Primary

Addresses

Primary practice location

1701 South Blvd E Ste 105
Rochester Hills, MI 48307-6121

Mailing address

405 Linkside CT
Saint Clair, MI 48079-3572
Phone (813) 344-8216

Other practice location 1

4600 Investment Dr Ste 100
Troy, MI 48098-6366
Phone (248) 312-0037

Other practice location 2

6700 N Rochester Rd Ste 101
Rochester Hills, MI 48306-4378
Phone (248) 601-1178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302032057MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Riteaid Past Accepting new patients
Lakshmi Pharmacy Enterprises LLC Pharmacist PastSince Mar 20, 2022 Accepting new patients
Lakshmi Pharmacy Enterprises LLC PastSince Mar 20, 2022 Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1205948957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LINKSIDE CT",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480793572",
            "telephone_number": "813-344-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 105",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076121",
            "telephone_number": "248-852-9355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Investment Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480986366",
            "country_code": "US",
            "telephone_number": "248-312-0037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6700 N Rochester Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483064378",
            "country_code": "US",
            "telephone_number": "248-601-1178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROCZOLOWSKI",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.