Organization Active NPI

Richard Grosso DC PC

  • Chiropractor
  • Mineola, NY
National Provider Identifier
1720176589
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X0069191 Issued in NY
Legal business name
RICHARD GROSSO DC PC
Practice address
195 Jericho Tpke
Mineola, NY 11501-1702
Phone
(516) 746-3135
Fax
(516) 746-3709
NPI assigned
Oct 10, 2006
Organization subpart
No

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

Authorized official

Name
Prof. Richard GrossoNPI 1295823052
Title
Owner
Phone
(516) 746-3135

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090205000651 NY Part B Supplier - Clinic/Group Practice 4587637103 Receives reassigned benefits from 1 practitioner
Practice locations: Mineola, NY

National Provider Directory

National Provider Directory

Locations

193 Jericho Tpke
#1
Mineola, NY 11501

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or 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-2",
    "last_updated_epoch": "1234224000000",
    "number": "1720176589",
    "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": "516-745-3709"
        },
        {
            "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": {
        "organization_name": "RICHARD GROSSO DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "GROSSO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-746-3135",
        "authorized_official_name_prefix": "Prof."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X0069191",
            "primary": true
        }
    ],
    "identifiers": [],
    "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.