Individual provider Active NPI

Jeraldine Mercado

  • Ambulatory Care Registered Nurse
  • Astoria, NY
National Provider Identifier
1407529225
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
804121 Issued in NY
Practice address
3459 Vernon Blvd Unit 2F
Astoria, NY 11106-5184
Phone
(916) 280-6481
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 804121 NY Primary

Addresses

Primary practice location

3459 Vernon Blvd Unit 2F
Astoria, NY 11106-5184

Mailing address

3459 Vernon Blvd Unit 2F
Astoria, NY 11106-5184
Phone (916) 280-6481

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
804121NYMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1407529225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3459 VERNON BLVD UNIT 2F",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111065184",
            "telephone_number": "916-280-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 VERNON BLVD UNIT 2F",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111065184",
            "telephone_number": "916-280-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "JERALDINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "804121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.