Individual provider Active NPI

Eugene-Joshua Rosario Mercado, OTR/L

  • Occupational Therapist
  • Hicksville, NY
National Provider Identifier
1174157663
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025373 Issued in NY
Practice address
84 Spindle Rd
Hicksville, NY 11801-6228
Phone
(516) 728-4247
NPI assigned
Feb 24, 2020
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 025373 NY Primary

Addresses

Primary practice location

84 Spindle Rd
Hicksville, NY 11801-6228

Mailing address

84 Spindle Rd
Hicksville, NY 11801-6228
Phone (516) 728-4247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302000105 NY Practitioner - Occupational Therapist in Private Practice 0345656294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6633 Yellowstone Blvd
Apt 3G
Forest Hills, NY 11375-2503
Phone (631) 275-8288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025373NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Function Occupational Therapy and Physical Therapy P.L.L.C. Occupational Therapist CurrentSince Jan 15, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1174157663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 SPINDLE RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016228",
            "telephone_number": "516-728-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 SPINDLE RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016228",
            "telephone_number": "516-728-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "EUGENE-JOSHUA",
        "middle_name": "ROSARIO",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.