Individual provider Active NPI

Agnieszka Mergo-Bielecka II

  • Pharmacist
  • Rego Park, NY
National Provider Identifier
1750551701
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02936400 Issued in NJ
Practice address
9511 63Rd Dr
Rego Park, NY 11374-2024
Phone
(718) 897-0803
Fax
(718) 897-0804
NPI assigned
Mar 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055647 NY
Pharmacist 183500000X 28RI02936400 NJ Primary

Addresses

Primary practice location

9511 63Rd Dr
Rego Park, NY 11374-2024

Mailing address

9511 63Rd Dr
Rego Park, NY 11374-2024
Phone (718) 897-0803

Other practice location 1

250 W 57th St
New York, NY 10107-0001
Phone (212) 265-2101

Other identifiers 1

IdentifierTypeStateIssuer
1295750768MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28RI02936400NJMDPharmacist
055647NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Duane Reade Past Accepting new patients
Duane Reade PastSince Apr 26, 2020 Accepting new patients
Duane Reade PastSince Apr 26, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1750551701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9511 63RD DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742024",
            "telephone_number": "718-897-0803",
            "fax_number": "718-897-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9511 63RD DR",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742024",
            "telephone_number": "718-897-0803",
            "fax_number": "718-897-0804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 W 57th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101070001",
            "country_code": "US",
            "telephone_number": "212-265-2101",
            "fax_number": "212-265-2105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERGO-BIELECKA",
        "first_name": "AGNIESZKA",
        "name_prefix": "Mrs.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055647",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02936400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295750768",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.