Gregorio Mercado Jr., PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

013319 Issued in AZ

Practice address

18622 W Colter St
Litchfield Park, AZ 85340-7503

Phone

(845) 594-4997

NPI assigned

Jul 15, 2022

Last updated

Jul 15, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1679207500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18622 W COLTER ST",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853407503",
            "telephone_number": "845-594-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18622 W COLTER ST",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853407503",
            "telephone_number": "845-594-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "GREGORIO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "013319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.