Individual provider Active NPI

Richard Grosso, D.C.

  • Chiropractor
  • Mineola, NY
National Provider Identifier
1295823052
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0069191 Issued in NY
Practice address
195 Jericho Tpke
Mineola, NY 11501-1702
Phone
(516) 746-3135
Fax
(516) 746-3709
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X0069191 NY Primary

Addresses

Primary practice location

195 Jericho Tpke
Mineola, NY 11501-1702

Mailing address

195 Jericho Tpke
Mineola, NY 11501
Phone (516) 746-3135

Other identifiers 1

IdentifierTypeStateIssuer
1122OtherNY1122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520001653 NY Practitioner - Chiropractic 0143211854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

195 Jericho Tpke
Mineola, NY 11501-1702
Phone (516) 746-3135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X0069191NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Grosso DC PC Chiropractor CurrentSince Feb 1, 2003 Accepting new patients

Locations

193 Jericho Tpke
#1
Mineola, NY 11501

193 Jericho Tpke
Mineola, NY 11501
Phone (516) 747-2323

Organizations & group practices 1

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1295823052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "11501",
            "telephone_number": "516-746-3135",
            "fax_number": "516-746-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011702",
            "telephone_number": "516-746-3135",
            "fax_number": "516-746-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSO",
        "first_name": "RICHARD",
        "name_prefix": "Prof.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0069191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1122",
            "identifier": "1122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.