Individual provider Active NPI

Mercedes Elena Camacho, NP

  • Family Nurse Practitioner
  • Union City, NJ
National Provider Identifier
1013069152
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NN92137 Issued in NJ
Practice address
3300 Hudson Ave
Union City, NJ 07087-5976
Phone
(201) 779-9910
Fax
(201) 325-9718
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NN92137 NJ Primary

Addresses

Primary practice location

3300 Hudson Ave
Union City, NJ 07087-5976

Mailing address

3300 Hudson Ave
Union City, NJ 07087-5976
Phone (201) 779-9910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050318000337 NJ Practitioner - Nurse Practitioner 6800846254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NN92137NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Past Accepting new patients
Columbia Advanced Nurse Practioners PastSince May 5, 2012 Accepting new patients
Emerson Physical Therapy and Rehabilitation ,Inc PastSince May 1, 2005 Accepting new patients

Organizations & group practices 3

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1013069152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 HUDSON AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875976",
            "telephone_number": "201-779-9910",
            "fax_number": "201-325-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 HUDSON AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875976",
            "telephone_number": "201-779-9910",
            "fax_number": "201-325-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "MERCEDES",
        "middle_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "NN92137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

Verify at the official NPI Registry.