Individual provider Active NPI

Carlos Mercedes, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1205069044
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031795-1 Issued in NY
Practice address
33 Irving PL
9TH Floor
New York, NY 10003-2332
Phone
(212) 677-3989
Fax
(212) 677-3994
NPI assigned
Aug 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 031795-1 NY Primary

Addresses

Primary practice location

33 Irving PL
9TH Floor
New York, NY 10003-2332

Mailing address

33 Irving PL
9TH Floor
New York, NY 10003-2332
Phone (212) 677-3989

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
031795-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist PastSince Oct 16, 2009 Accepting new patients
Encompass Health Rehabilitation Hospital of Florence, Inc. Past Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1205069044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 IRVING PL",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032332",
            "telephone_number": "212-677-3989",
            "fax_number": "212-677-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 IRVING PL",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032332",
            "telephone_number": "212-677-3989",
            "fax_number": "212-677-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCEDES",
        "first_name": "CARLOS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031795-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.