Organization Active NPI

Marylou Romo-Gritzewsky

  • Internal Medicine Physician
  • Freedom, CA
National Provider Identifier
1689778607
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76531 Issued in CA
Legal business name
MARYLOU ROMO-GRITZEWSKY
Practice address
268 Green Valley Rd
Freedom, CA 95019-3139
Phone
(831) 728-0440
Fax
(831) 728-4293
NPI assigned
Sep 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marylou Romo-Gritzewsky, MDNPI 1790795730
Title
Physician
Phone
(831) 728-0440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A76531 CA Primary

Addresses

Primary practice location

268 Green Valley Rd
Freedom, CA 95019-3139

Mailing address

268 Green Valley Rd
Freedom, CA 95019-3139
Phone (831) 728-0440

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0925390Marylou Romo-Gritzewsky268 Green Valley Road, Freedom, CA 95019Certificate of waiverFeb 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689778607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 GREEN VALLEY RD",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193139",
            "telephone_number": "831-728-0440",
            "fax_number": "831-728-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 GREEN VALLEY RD",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193139",
            "telephone_number": "831-728-0440",
            "fax_number": "831-728-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLOU ROMO-GRITZEWSKY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROMO-GRITZEWSKY",
        "authorized_official_first_name": "MARYLOU",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "831-728-0440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freedom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.