Individual provider Active NPI

Elizma Eksteen Mercier, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Gainesville, FL
National Provider Identifier
1003030289
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9103884 Issued in FL
Practice address
5612 NW 43Rd St
Gainesville, FL 32653-3332
Phone
(352) 376-4542
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9103884 FL Primary

Addresses

Primary practice location

5612 NW 43Rd St
Gainesville, FL 32653-3332

Mailing address

10012 SW 93Rd PL
Gainesville, FL 32608-5993
Phone (352) 495-0844

Other identifiers 2

IdentifierTypeStateIssuer
O9719OtherFLHF MA
114127200MedicaidFL

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9103884FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et1426.epichosted.com/FHIRProxyPRD/api/FHIR/R4
  • FHIR API: https://api.platform.athenahealth.com/3681/brand/8/csg/121/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1003030289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 SW 93RD PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326085993",
            "telephone_number": "352-495-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5612 NW 43RD ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326533332",
            "telephone_number": "352-376-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCIER",
        "first_name": "ELIZMA",
        "middle_name": "EKSTEEN",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HF MA",
            "identifier": "O9719",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114127200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

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