Individual provider Active NPI

Marriliz Serrano Mendez, BSN

  • General Practice Registered Nurse
  • Moca, PR
National Provider Identifier
1154894418
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
82612 Issued in PR
Practice address
Moca Professional Plaza Pr111 Int PR 110 KM 14.5
Moca, PR 00676
Phone
(787) 641-0773
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 82612 PR Primary

Addresses

Primary practice location

Moca Professional Plaza Pr111 Int PR 110 KM 14.5
Moca, PR 00676

Mailing address

Moca Professional Plaza Pr111 Int PR 110 KM 14.5
Moca, PR 00676
Phone (787) 641-0773

Other identifiers 1

IdentifierTypeStateIssuer
6014471MedicaidPR

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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
82612PRMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1546992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1154894418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MOCA PROFESSIONAL PLAZA PR111 INT PR 110 KM 14.5",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "787-641-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MOCA PROFESSIONAL PLAZA PR111 INT PR 110 KM 14.5",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "00676",
            "telephone_number": "787-641-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO MENDEZ",
        "first_name": "MARRILIZ",
        "name_prefix": "Miss",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-09",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "PR",
            "license": "82612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6014471",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moca, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.