Central Mesa Medical PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

03289 Issued in AZ

Legal business name

CENTRAL MESA MEDICAL PC

Practice address

204 N Center St
Mesa, AZ 85201-6629

Phone

(480) 962-0868

Fax

(480) 962-7010

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Scott L Miritello, D.C.NPI 1912092289

Title

President

Phone

(480) 962-0868

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott L Miritello, D.C.

  • Chiropractor
  • Mesa, AZ
  • NPI 1912092289
  Medicare reassignment Care Compare group NPD Authorized official
• Leanne J Koleski, NP-C

  • Adult Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1619209392
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415664000000",
    "number": "1669509568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N CENTER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016629",
            "telephone_number": "480-962-0868",
            "fax_number": "480-962-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N CENTER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016629",
            "telephone_number": "480-962-0868",
            "fax_number": "480-962-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MESA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-11-11",
        "status": "A",
        "authorized_official_last_name": "MIRITELLO",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-962-0868",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "03289",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "21507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; 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.