Individual provider Active NPI

Angela Y Mercedes, FNP

  • Nurse Practitioner
  • Port Chester, NY
National Provider Identifier
1306188313
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
337751 Issued in NY
Practice address
5 Grace Church St
Port Chester, NY 10573-4911
Phone
(914) 937-8899
Fax
(914) 937-7932
NPI assigned
Mar 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 337751 NY Primary

Addresses

Primary practice location

5 Grace Church St
Port Chester, NY 10573-4911

Mailing address

165 Main St
Ossining, NY 10562-4702
Phone (914) 941-1263

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
I20150107000495 NY Practitioner - Nurse Practitioner 0143452458 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
337751NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Refuah Health Center Inc CurrentSince Feb 1, 2020 Accepting new patients
Refuah Health Center, Inc. CurrentSince Feb 1, 2020 Accepting new patients

Locations

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

Organizations & group practices 2

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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1306188313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899",
            "fax_number": "914-937-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCEDES",
        "first_name": "ANGELA",
        "middle_name": "Y",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "337751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.