Active NPI
Dominic Mark Scorziello, RPH
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1255574950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302027977
- Practice address
- 800 Leonard St NW
Grand Rapids, MI 49504-4148 - Phone
- (616) 458-8300
- Fax
- (616) 458-3691
- NPI assigned
- Apr 9, 2009
- Last updated
- Apr 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI01836400 | NJ | |
| Pharmacist | 183500000X | 5302027977 | MI | Primary |
Addresses
Primary practice location
800 Leonard St NW
Grand Rapids, MI 49504-4148
Mailing address
800 Leonard St NW
Grand Rapids, MI 49504-4148
Phone (616) 458-8300
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302027977 | MI | MD | Pharmacist |
| 28RI01836400 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Rite Aid of Michigan Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Rite Aid of Michigan Inc | Past | Accepting new patients |
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.
-
dba Rite Aid Pharmacy 04068
- Community/Retail Pharmacy
- Washington, MI
- NPI 1619117405
-
dba Rite Aid Pharmacy 01526
- Community/Retail Pharmacy
- Cedar Springs, MI
- NPI 1770692212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651276800000",
"number": "1255574950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 LEONARD ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495044148",
"telephone_number": "616-458-8300",
"fax_number": "616-458-3691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 LEONARD ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495044148",
"telephone_number": "616-458-8300",
"fax_number": "616-458-3691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCORZIELLO",
"first_name": "DOMINIC",
"middle_name": "MARK",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-09",
"last_updated": "2022-04-30",
"certification_date": "2022-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI01836400",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302027977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.