Individual provider Active NPI

Mercedes Torres-Rodriguez, D.D.S.

  • Dentist
  • New York, NY
National Provider Identifier
1750453882
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045187-1 Issued in NY
Practice address
219 Audubon Ave Apt 1B2
New York, NY 10033-8316
Phone
(212) 923-3662
NPI assigned
Nov 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 045187-1 NY Primary

Addresses

Primary practice location

219 Audubon Ave Apt 1B2
New York, NY 10033-8316

Mailing address

900 W 190TH St Apt 4D
New York, NY 10040-3655
Phone (212) 923-3662

Other identifiers 1

IdentifierTypeStateIssuer
01477361MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150625001670 NY Order and Referring Only - DentistPractitioner - Dentist 9931410370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045187-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750453882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W 190TH ST APT 4D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403655",
            "telephone_number": "212-923-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 AUDUBON AVE APT 1B2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100338316",
            "telephone_number": "212-923-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES-RODRIGUEZ",
        "first_name": "MERCEDES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045187-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01477361",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.