Individual provider Active NPI

Maria Richelle Mauricio-Halagao, LPN

  • Licensed Practical Nurse
  • Bronx, NY
National Provider Identifier
1114596236
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
34146201 Issued in NY
Practice address
1170 Astor Ave Apt 2
Bronx, NY 10469-5435
Phone
(917) 605-2777
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 34146201 NY Primary

Addresses

Primary practice location

1170 Astor Ave Apt 2
Bronx, NY 10469-5435

Mailing address

1170 Astor Ave Apt 2
Bronx, NY 10469-5435
Phone (917) 605-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
34146201NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1114596236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 ASTOR AVE APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695435",
            "telephone_number": "917-605-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 ASTOR AVE APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695435",
            "telephone_number": "917-605-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO-HALAGAO",
        "first_name": "MARIA RICHELLE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "34146201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.