Active NPI
Mario Nelson, MD
- Physical Medicine & Rehabilitation Physician
- Valhalla, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 163147
- Practice address
- 100 Woods Rd
Valhalla, NY 10595-1530 - Phone
- (914) 493-8051
- Fax
- (914) 493-7637
- NPI assigned
- Dec 1, 2005
- Last updated
- Dec 16, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 163147 | NY | Primary |
Addresses
Primary practice location
100 Woods Rd
Valhalla, NY 10595-1530
Mailing address
100 Woods Rd
Valhalla, NY 10595-1530
Phone (914) 493-8051
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00911046 | Medicaid | NY | |
| 163147 | Other | LICENSE |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 163147 | NY | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Throgs Neck Multi Care, P.C. | Current | Accepting new patients | |
| Westchester Medical Center Advanced Physician Services PC | Current | Accepting new patients | |
| Westchester Medical Center Advanced Physician Services, PC | Physical Medicine & Rehabilitation | Current | Accepting new patients |
| Our Lady of Mercy Ambulatory Care Center, Inc. | Past | Accepting new patients | |
| Our Lady of Mercy Medical Center | Past | Accepting new patients |
Locations
3058 E Tremont Ave
Bronx, NY 10461
Phone (718) 409-0500
19 Bradhurst Ave
Ste 1700S
Hawthorne, NY 10532
Phone (914) 347-0162
19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373
100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000
95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450224000000",
"number": "1386628550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WOODS RD",
"city": "VALHALLA",
"state": "NY",
"postal_code": "105951530",
"telephone_number": "914-493-8051",
"fax_number": "914-493-7637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WOODS RD",
"city": "VALHALLA",
"state": "NY",
"postal_code": "105951530",
"telephone_number": "914-493-8051",
"fax_number": "914-493-7637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MARIO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2015-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NY",
"license": "163147",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00911046",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "163147",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Valhalla, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.