Greg J. Mercurio, MD, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0060051 Issued in FL

Legal business name

GREG J. MERCURIO, MD, PA

Practice address

1720 State Road 44
New Smyrna Beach, FL 32168-8339

Phone

(386) 427-8008

Fax

(386) 402-4309

NPI assigned

Oct 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gregory James Mercurio, MDNPI 1194839977

Title

President

Phone

(386) 427-8008

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Causeway Medical Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory James Mercurio, MD

  • Internal Medicine Physician
  • New Smyrna Beach, FL
  • NPI 1194839977
  Medicare reassignment NPD Authorized official
• Staci Appleton, MD

  • Internal Medicine Physician
  • Edgewater, FL
  • NPI 1427162189
  NPD (past)
• Kelli Nicole Bridgman, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Deland, FL
  • NPI 1588841977
  NPD (past)
• Antony B Codrington

  • Physical Therapist
  • New Smyrna Beach, FL
  • NPI 1669644688
  NPD (past)
• Rebecca Cristine McCracken, DPT

  • Physical Therapist
  • Port Orange, FL
  • NPI 1093825960
  NPD (past)
• Jana Lynn Moore, PTA

  • Physical Therapy Assistant
  • New Smyrna Beach, FL
  • NPI 1467669366
  NPD (past)
• Michelle Lynn Reynolds, PT

  • Physical Therapist
  • New Smyrna Beach, FL
  • NPI 1922199926
  NPD (past)

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588550400000",
    "number": "1053508283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 STATE ROAD 44",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688339",
            "telephone_number": "386-427-8008",
            "fax_number": "386-423-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 STATE ROAD 44",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688339",
            "telephone_number": "386-427-8008",
            "fax_number": "386-402-4309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREG J. MERCURIO, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "MERCURIO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-427-8008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0060051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC6447",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Causeway Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Causeway Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Greco
• Emily Rebekah Green, PA-C.
• Greene Urological Center P.a.
• Karla Noelle Greene, D.C.
• Gordon G Greenhalgh, PHD
• Gregory P. Samano D.O., P.a.
• Emily Gregory
• Stephen Patrick Griffith, MD
• Myriam F Grondal
• Amy M Grossi, CLC

• Internal Medicine Physician in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.