Individual provider Active NPI

Michael Raymond Goretti, PHARMD

  • Pharmacist
  • North Andover, MA
National Provider Identifier
1760086292
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH236020 Issued in MA
Practice address
125 Boston St
North Andover, MA 01845-6224
Phone
(508) 277-3469
NPI assigned
Nov 25, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH236020 MA Primary

Addresses

Primary practice location

125 Boston St
North Andover, MA 01845-6224

Mailing address

125 Boston St
North Andover, MA 01845-6224
Phone (508) 277-3469

Other identifiers 1

IdentifierTypeStateIssuer
PH236020OtherMAPHARMACY LICENSE

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH236020MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1760086292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BOSTON ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456224",
            "telephone_number": "508-277-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BOSTON ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456224",
            "telephone_number": "508-277-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORETTI",
        "first_name": "MICHAEL",
        "middle_name": "RAYMOND",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH236020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PH236020",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.