NPIMap

Individual provider Active NPI

Marissa Maricel Armamento Mercado, MD

  • Family Medicine Physician
  • Hoschton, GA
National Provider Identifier
1649408667
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
067505 Issued in GA
Practice address
26 W Jackson Commons Dr
Hoschton, GA 30548-1897
Phone
(770) 848-9190
NPI assigned
Jun 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 067505 GA Primary

Addresses

Primary practice location

26 W Jackson Commons Dr
Hoschton, GA 30548-1897

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

115 Towne Center Pkwy
Suite #113
Hoschton, GA 30548-2213
Phone (706) 658-2452

Other identifiers 2

IdentifierTypeStateIssuer
20208I2361OtherGAMEDICARE PTAN#
003124550AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmercado29401@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120620000699 GA Practitioner - Family Practice 3375707482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

26 W Jackson Commons Dr
Hoschton, GA 30548-1897
Phone (706) 658-2452

597 S Enota Dr NE
Gainesville, GA 30501-2545
Phone (770) 219-7777

PO Box
Suite 1060
Oakwood, GA 30566-0018

Hospital & facility affiliations

  • Pruitthealth at Home - Atlanta Home health agency, Norcross, GA, CCN 117118
  • Amedisys Home Health of Covington Home health agency, Covington, GA, CCN 117065
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
Northeast Georgia Physicians Group Urgent Care LLC Family Medicine Past Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

26 W Jackson Commons Dr
Hoschton, GA 30548
Phone (706) 658-2452

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.

Hospital & facility affiliations 11

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1649408667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420",
            "fax_number": "770-219-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W JACKSON COMMONS DR",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305481897",
            "telephone_number": "770-848-9190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Towne Center Pkwy",
            "address_2": "Suite #113",
            "address_purpose": "LOCATION",
            "city": "Hoschton",
            "state": "GA",
            "postal_code": "305482213",
            "country_code": "US",
            "telephone_number": "706-658-2452",
            "fax_number": "706-658-2462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "MARISSA MARICEL",
        "middle_name": "ARMAMENTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "067505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "20208I2361",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124550A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmercado29401@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "26 W Jackson Commons Dr",
            "city": "Hoschton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305481897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoschton, GA

Sources for this page

Verify at the official NPI Registry.