Individual provider Active NPI

Marielly Sierra Mercado, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • San Juan, PR
National Provider Identifier
1013258482
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
19192 Issued in PR
Practice address
University District Hospital
Medical Center Bo Monacillos
San Juan, PR 00935
Phone
(787) 754-0101
NPI assigned
Mar 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 19192 PR
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 19192 PR Primary

Addresses

Primary practice location

University District Hospital
Medical Center Bo Monacillos
San Juan, PR 00935

Mailing address

PO Box 366791
San Juan, PR 00936-6791
Phone (787) 754-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190214002620 PR Practitioner - Endocrinology 1153669213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

382 Calle Manuel Domenech
San Juan, PR 00918-3719
Phone (787) 945-7797

Hospital & facility affiliations

  • Bayamon Medical Center Hospital, Bayamon, PR, CCN 400032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19192PRMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Endocrinology Services Endocrinology, Diabetes & Metabolism CurrentSince Aug 1, 2018 Accepting new patients
Pro-Health Clinical Services LLC Endocrinology, Diabetes & Metabolism CurrentSince Feb 27, 2019 Accepting new patients

Locations

382 Calle Manuel Domenech
San Juan, PR 00918
Phone (787) 604-0436

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1013258482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366791",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009366791",
            "telephone_number": "787-754-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY DISTRICT HOSPITAL",
            "address_2": "MEDICAL CENTER BO MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00935",
            "telephone_number": "787-754-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERRA MERCADO",
        "first_name": "MARIELLY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "19192",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PR",
            "license": "19192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.