Active NPI
Merry Ann Hugo Fernandez, RPT
- Physical Therapist
- Woodside, NY
National Provider Identifier
1205147014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 026143
- Practice address
- 4277 65TH PL
Woodside, NY 11377-5054 - Phone
- (718) 429-2000
- NPI assigned
- Jun 25, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 026143 | NY | Primary |
| Pediatric Physical Therapist | 2251P0200X | 026143-1 | NY |
Addresses
Primary practice location
4277 65TH PL
Woodside, NY 11377-5054
Mailing address
8511 57TH Ave FL 3
Elmhurst, NY 11373-4835
Phone (646) 420-3474
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026143-1 | NY | MD | Pediatric Physical Therapist |
| 026143 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1205147014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8511 57TH AVE FL 3",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113734835",
"telephone_number": "646-420-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4277 65TH PL",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113775054",
"telephone_number": "718-429-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "MERRY ANN HUGO",
"name_prefix": "Ms.",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-25",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "026143",
"primary": true
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "NY",
"license": "026143-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.