Individual provider Active NPI

Scott L Miritello, D.C.

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1912092289
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03289 Issued in AZ
Practice address
204 N Center St
Mesa, AZ 85201-6629
Phone
(480) 962-0868
Fax
(480) 962-7010
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 03289 AZ Primary

Addresses

Primary practice location

204 N Center St
Mesa, AZ 85201-6629

Mailing address

204 N Center St
Mesa, AZ 85201-6629
Phone (480) 962-0868

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000730 AZ Practitioner - Chiropractic 9638366818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Mesa Medical PCGroup PAC ID 1355320318, 2 clinicians

Practice addresses (Care Compare)

204 N Ctr St
Mesa, AZ 85201-6629
Phone (480) 962-0868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03289AZMDChiropractor
3289AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Mesa Medical PC Chiropractor CurrentSince Sep 18, 1997 Accepting new patients

Locations

204 N Center St
Mesa, AZ 85201
Phone (480) 962-0868

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1912092289",
    "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": {
        "last_name": "MIRITELLO",
        "first_name": "SCOTT",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "03289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.