Individual provider Active NPI

Stephen Crocco

  • Pharmacist
  • Houston, TX
National Provider Identifier
1710164082
Registry record updated Dec 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
047528 Issued in NY
Practice address
747 E Crosstimbers St
Houston, TX 77022-3725
Phone
(713) 695-2427
Fax
(713) 695-2427
NPI assigned
Jan 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 047528 NY Primary

Addresses

Primary practice location

747 E Crosstimbers St
Houston, TX 77022-3725

Mailing address

747 E Crosstimbers St
Houston, TX 77022-3725
Phone (713) 695-2427

Other practice location 1

259 Saratoga Rd
Scotia, NY 12302-4503
Phone (518) 399-6351

Other identifiers 1

IdentifierTypeStateIssuer
00535997MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jan 1, 2023 Accepting new patients
CVS Albany LLC Past Accepting new patients
Walgreen Co PastSince Jan 1, 2023 Accepting new patients
CVS Albany LLC Past Accepting new patients

Locations

747 E Crosstimbers St
Houston, TX 77022
Phone (713) 695-2427

Organizations & group practices 4

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1710164082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 E CROSSTIMBERS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770223725",
            "telephone_number": "713-695-2427",
            "fax_number": "713-695-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 E CROSSTIMBERS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770223725",
            "telephone_number": "713-695-2427",
            "fax_number": "713-695-2427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "259 Saratoga Rd",
            "address_purpose": "LOCATION",
            "city": "Scotia",
            "state": "NY",
            "postal_code": "123024503",
            "country_code": "US",
            "telephone_number": "518-399-6351",
            "fax_number": "518-399-0259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCCO",
        "first_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00535997",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.