Individual provider Active NPI

Lisa A Mercado, MSED

  • Specialist
  • Amityville, NY
National Provider Identifier
1407693583
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
99 Central Ave
Amityville, NY 11701-3537
Phone
(516) 317-9284
NPI assigned
Jul 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

99 Central Ave
Amityville, NY 11701-3537

Mailing address

21 Peachtree CT
Holtsville, NY 11742-2534
Phone (631) 258-4198

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

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1407693583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 PEACHTREE CT",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422534",
            "telephone_number": "631-258-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CENTRAL AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013537",
            "telephone_number": "516-317-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.