Mark Mongillo, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

058233 Issued in NY

Practice address

1727 Black River Blvd N
Rome, NY 13440-2425

Phone

(315) 336-8890

NPI assigned

Jul 24, 2013

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eckerd Corporation

  dba Rite Aid Pharmacy 10796

  • Community/Retail Pharmacy
  • Oneonta, NY
  • NPI 1871694687
  NPD (past)
• Eckerd Corporation

  dba Rite Aid Pharmacy 11268

  • Community/Retail Pharmacy
  • Virginia Beach, VA
  • NPI 1982703120
  NPD (past)

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1982046470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 BLACK RIVER BLVD N",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402425",
            "telephone_number": "315-336-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 BLACK RIVER BLVD N",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402425",
            "telephone_number": "315-336-8890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Oneonta",
            "state": "NY",
            "postal_code": "138202470",
            "country_code": "US",
            "telephone_number": "607-432-7640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONGILLO",
        "first_name": "MARK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP447842",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "058233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohawk Glen Radiology Associates of Cny PLLC
• Mohawk Glen Urgent Care, PLLC
• Mohawk Valley Open MRI, PC
• Mohawk Valley Womens Health Associates LLP
• Samuel Molica, DO
• Phyllis R Moore, MSW
• Ronald Moore, DC
• Jose Morales, LPN
• Celena Moulton
• Jullien Mowatt, NP

• Pharmacist in Rome, NY
• Providers in Rome, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.