Individual provider Active NPI

Alexa A Decerce, FNP-BC

  • Family Nurse Practitioner
  • Halfmoon, NY
National Provider Identifier
1184404998
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352458 Issued in NY
Practice address
3 Executive Park Dr
Halfmoon, NY 12065-6651
Phone
(518) 371-4614
NPI assigned
Oct 2, 2023
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 352458 NY Primary

Addresses

Primary practice location

3 Executive Park Dr
Halfmoon, NY 12065-6651

Mailing address

3 Executive Park Dr
Halfmoon, NY 12065-6651

Other practice location 1

700 McClellan St
Schenectady, NY 12304-1019
Phone (518) 374-9153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240110003098 NY Practitioner - Nurse Practitioner 6204287618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Mondragon McGrinder Medical Associates PLLCGroup PAC ID 8123174075, 5 clinicians

Practice addresses (Care Compare)

700 McClellan St
Schenectady, NY 12304-1019
Phone (518) 374-9153

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
352458NYMDFamily Nurse Practitioner

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.

Hospital & facility affiliations 3

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": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1184404998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EXECUTIVE PARK DR",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120656651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 EXECUTIVE PARK DR",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120656651",
            "telephone_number": "518-371-4614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 McClellan St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123041019",
            "country_code": "US",
            "telephone_number": "518-374-9153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECERCE",
        "first_name": "ALEXA",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Halfmoon, NY

Sources for this page

Verify at the official NPI Registry.