Active NPI
Jay Mermelstein, DPM
- Podiatrist
- Mount Vernon, NY
National Provider Identifier
1275720922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 25MD00251400
- Practice address
- 105 Stevens Ave
Suite 301
Mount Vernon, NY 10550-2686 - Phone
- (914) 699-1515
- Fax
- (914) 699-2907
- NPI assigned
- Sep 26, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | N004414 | NY | |
| Podiatrist | 213E00000X | 25MD00251400 | NJ | Primary |
Addresses
Primary practice location
105 Stevens Ave
Suite 301
Mount Vernon, NY 10550-2686
Mailing address
105 Stevens Ave
Suite 301
Mount Vernon, NY 10550-2686
Phone (914) 699-1515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01084459 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N004414 | NY | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jay Mermelstein, DPM.PC | Past | 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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Mount Vernon, NY
- NPI 1538306212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1275720922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 STEVENS AVE",
"address_2": "SUITE 301",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105502686",
"telephone_number": "914-699-1515",
"fax_number": "914-699-2907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 STEVENS AVE",
"address_2": "SUITE 301",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105502686",
"telephone_number": "914-699-1515",
"fax_number": "914-699-2907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERMELSTEIN",
"first_name": "JAY",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-26",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NY",
"license": "N004414",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NJ",
"license": "25MD00251400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01084459",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.