Individual provider Active NPI

Avalon Alyssa Mercado, PA-C

  • Physician Assistant
  • Manchester, NH
National Provider Identifier
1407569742
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2163 Issued in NH
Practice address
1 Elliot Way
Manchester, NH 03103-3502
Phone
(603) 663-3437
NPI assigned
Jan 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2163 NH Primary

Addresses

Primary practice location

1 Elliot Way
Manchester, NH 03103-3502

Mailing address

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 663-3437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20240327002380 NH Practitioner - Physician Assistant 3072950948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 314-6900

25 Leavey Dr
Bedford, NH 03110-4437
Phone (603) 663-3740

40 Butrrick Rd
Londonderry, NH 03053-3381

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2163NHMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: amercado143865@direct.solutionhealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1407569742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELLIOT WAY",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033502",
            "telephone_number": "603-663-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "AVALON",
        "middle_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-02",
        "last_updated": "2024-03-01",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.