Individual provider Active NPI

Dominic Morgillo

  • Psychiatric/Mental Health Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1285498469
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN.475790 Issued in OH
Practice address
3909 Woodley Rd
Toledo, OH 43606-1169
Phone
(419) 725-3330
NPI assigned
Feb 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN.475790 OH Primary

Addresses

Primary practice location

3909 Woodley Rd
Toledo, OH 43606-1169

Mailing address

3909 Woodley Rd
Toledo, OH 43606-1169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129000082 OH Practitioner - Nurse Practitioner 9638608102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HarborGroup PAC ID 8325931181, 58 clinicians

Practice addresses (Care Compare)

3909 Woodley Rd
Toledo, OH 43606-1169
Phone (419) 475-4449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.475790OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor CurrentSince Nov 16, 2024 Accepting new patients
Harbor Past Accepting new patients
Harbor Past Accepting new patients

Locations

3909 Woodley Rd
Toledo, OH 43606
Phone (419) 725-3330

123 22nd St
Toledo, OH 43604
Phone (419) 241-6191

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": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1285498469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169",
            "telephone_number": "419-725-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGILLO",
        "first_name": "DOMINIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.475790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.