Individual provider Active NPI

Mark Mercieca

  • Home Health Aide
  • Okemos, MI
National Provider Identifier
1801570585
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
1770087587 Issued in MI
Practice address
2175 Jolly Rd Ste 3
Okemos, MI 48864-9825
Phone
(517) 709-2240
NPI assigned
Jun 13, 2023
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X MI
Home Health Aide 374U00000X 1770087587 MI Primary

Addresses

Primary practice location

2175 Jolly Rd Ste 3
Okemos, MI 48864-9825

Mailing address

2175 Jolly Rd Ste 3
Okemos, MI 48864-9825
Phone (517) 709-2240

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
1770087587MIMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Angeltime Inc. CurrentSince Jun 18, 2023 Accepting new patients

Locations

2175 Jolly Rd
Ste 3
Okemos, MI 48864
Phone (517) 709-2240

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1801570585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 JOLLY RD STE 3",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488649825",
            "telephone_number": "517-709-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 JOLLY RD STE 3",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488649825",
            "telephone_number": "517-709-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCIECA",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MI",
            "license": "1770087587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.