NPIMap

Organization Active NPI

Mercy Internal Medicine PC

  • Internal Medicine Physician
  • Rockville Centre, NY
National Provider Identifier
1376734079
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
178140 Issued in NY
Legal business name
MERCY INTERNAL MEDICINE PC
Practice address
1000 N. Village Avenue
Rockville Centre, NY 11571
Phone
(516) 705-1353
NPI assigned
Aug 7, 2007
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
John Reilly, MDNPI 1952453797
Title
Direcor
Phone
(516) 705-1353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 178140 NY Primary

Addresses

Primary practice location

1000 N. Village Avenue
Rockville Centre, NY 11571

Mailing address

P.O. Box 798
Rockville Centre, NY 11571
Phone (516) 705-1353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326000445 NY Part B Supplier - Clinic/Group Practice 3173609591 Receives reassigned benefits from 30 practitioners
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1376734079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 798",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11571",
            "telephone_number": "516-705-1353",
            "fax_number": "516-705-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N. VILLAGE AVENUE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11571",
            "telephone_number": "516-705-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECOR",
        "authorized_official_telephone_number": "516-705-1353",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "178140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.