Individual provider Active NPI

Myra E Mercado, MD

  • Neonatal-Perinatal Medicine Physician
  • Valhalla, NY
National Provider Identifier
1427050277
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
188474 Issued in NY
Practice address
100 Woods Rd
Westchester Medical Center-Pediatrics
Valhalla, NY 10595-1530
Phone
(914) 493-8558
Fax
(914) 493-1488
NPI assigned
Aug 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 188474 NY Primary

Addresses

Primary practice location

100 Woods Rd
Westchester Medical Center-Pediatrics
Valhalla, NY 10595-1530

Mailing address

22 Saw Mill River Rd
2ND Floor
Hawthorne, NY 10532-1533
Phone (914) 493-8558

Other identifiers 1

IdentifierTypeStateIssuer
01369295MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051210000042 NY Practitioner - Pediatric Medicine 8426079005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
188474NYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 30, 2019 Accepting new patients
Boston Children'S Health Physicians, LLP Neonatal-Perinatal Medicine Past Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

100 Woods Rd
Valhalla, NY 10595
Phone (914) 490-7000

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1427050277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SAW MILL RIVER RD",
            "address_2": "2ND FLOOR",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321533",
            "telephone_number": "914-493-8558",
            "fax_number": "914-493-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "address_2": "WESTCHESTER MEDICAL CENTER-PEDIATRICS",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "914-493-8558",
            "fax_number": "914-493-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "MYRA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "188474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01369295",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.