Individual provider Active NPI

Nick Gasso

  • Pharmacist
  • Sterling Heights, MI
National Provider Identifier
1629429493
Registry record updated May 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032180 Issued in MI
Practice address
38924 Dequindre Rd
Sterling Heights, MI 48310-2890
Phone
(586) 983-9740
NPI assigned
Jun 23, 2016
Last updated
May 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032180 MI Primary
Ambulatory Care Pharmacist 1835P2201X 5302032180 MI

Addresses

Primary practice location

38924 Dequindre Rd
Sterling Heights, MI 48310-2890

Mailing address

5603 Victoria Dr
West Bloomfield, MI 48322-1138
Phone (248) 880-7009

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
5302032180MIMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Afkn LLC CurrentSince May 29, 2022 Accepting new patients

Locations

38924 Dequindre Rd
Sterling Heights, MI 48310
Phone (586) 983-9740

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653091200000",
    "number": "1629429493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 VICTORIA DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221138",
            "telephone_number": "248-880-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38924 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483102890",
            "telephone_number": "586-983-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASSO",
        "first_name": "NICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2022-05-21",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032180",
            "primary": true
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MI",
            "license": "5302032180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.