NPIMap

Organization Active NPI

Melissa Mercogliano, PT, PS

  • Physical Therapist
  • Port Orchard, WA
National Provider Identifier
1710070362
Registry record updated Jul 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00003857 Issued in WA
Legal business name
MELISSA MERCOGLIANO, PT, PS
Practice address
463 Tremont Street West
Ste 100
Port Orchard, WA 98366
Phone
(360) 874-0745
Fax
(360) 874-0846
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2020

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

Authorized official

Name
Dr. Melissa Authier Mercogliano, PT, DPT, OCS
Title
President
Phone
(360) 874-0745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT00003857 WA Primary

Addresses

Primary practice location

463 Tremont Street West
Ste 100
Port Orchard, WA 98366

Mailing address

463 Tremont Street West
Ste 100
Port Orchard, WA 98366
Phone (360) 874-0745

Other identifiers 4

IdentifierTypeStateIssuer
472217001OtherWAALLIANCE
137035OtherWALABOR AND INDUSTRIES WA
5214359OtherAETNA
5414MEOtherWAREGENCE

Other names 1

  • Center for Orthopedic & Lymphatic Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

2505 SE Mile Hill Dr
Ste B23
Port Orchard, WA 98366
Phone (360) 633-6735

2505 SE Mile Hill Dr
Port Orchard, WA 98366
Phone (360) 874-0745

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593734400000",
    "number": "1710070362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 TREMONT STREET WEST",
            "address_2": "STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "98366",
            "telephone_number": "360-874-0745",
            "fax_number": "360-874-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 TREMONT STREET WEST",
            "address_2": "STE 100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "98366",
            "telephone_number": "360-874-0745",
            "fax_number": "360-874-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA MERCOGLIANO, PT, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A",
        "authorized_official_last_name": "MERCOGLIANO",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "AUTHIER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-874-0745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00003857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "472217001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES WA",
            "identifier": "137035",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5214359",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5414ME",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Orthopedic & Lymphatic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Orthopedic & Lymphatic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.