Active NPI
Elisa J Mercuro, DO
- Family Medicine Physician
- Derry, NH
National Provider Identifier
1609860352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 12395
- Practice address
- 6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584 - Phone
- (603) 537-1300
- Fax
- (603) 537-1355
- NPI assigned
- Sep 8, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 12395 | NH | Primary |
Addresses
Primary practice location
6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Mailing address
6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Phone (603) 537-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30223121 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2017 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkland Physician Services Inc | Past | Accepting new patients | |
| Parkland Physician Services, Inc. | Family Medicine | Past | Accepting new patients |
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.
-
- Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
- Derry, NH
- NPI 1740409556
-
- Endocrinology, Diabetes & Metabolism Physician
- Derry, NH
- NPI 1144388737
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609860352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 TSIENNETO RD",
"address_2": "SUITE 100",
"city": "DERRY",
"state": "NH",
"postal_code": "030381584",
"telephone_number": "603-537-1300",
"fax_number": "603-537-1355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 TSIENNETO RD",
"address_2": "SUITE 100",
"city": "DERRY",
"state": "NH",
"postal_code": "030381584",
"telephone_number": "603-537-1300",
"fax_number": "603-537-1355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCURO",
"first_name": "ELISA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "12395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30223121",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Derry, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.