Individual provider Active NPI

Gabriel Josue Sustache Mercado, APRN

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1013671569
Registry record updated Jun 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11015750 Issued in FL
Practice address
4500 Pleasant Hill Rd
Kissimmee, FL 34746-2724
Phone
(866) 389-2727
NPI assigned
Oct 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11015750 FL
Adult Health Nurse Practitioner 363LA2200X APRN11015750 FL
Family Nurse Practitioner 363LF0000X APRN11015750 FL Primary

Addresses

Primary practice location

4500 Pleasant Hill Rd
Kissimmee, FL 34746-2724

Mailing address

4500 Pleasant Hill Rd
Kissimmee, FL 34746-2724
Phone (866) 389-2727

Other practice location 1

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (321) 841-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220323002985 FL Practitioner - Nurse Practitioner 3173918463 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

10701 International Dr
Orlando, FL 32821-7392
Phone (866) 389-2727

121 W Macclenny Ave
Macclenny, FL 32063-2029
Phone (866) 389-2727

13454 S Orange Blossom TRL
FL 4
Orlando, FL 32837-6601
Phone (866) 389-2727

1800 E Hwy 50
Clermont, FL 34711-1914
Phone (866) 389-2727

2454 E Irlo Bronson Memorial Hwy
Kissimmee, FL 34744-5431
Phone (866) 389-2727

2831 Maguire Rd
Windermere, FL 34786-6057
Phone (866) 389-2727

7599 W Sand Lake Rd
Orlando, FL 32819-5109
Phone (866) 389-2727

Merit-based Incentive Payment System (MIPS)

Final score
77.37 of 100Reported as group
Quality
74
Improvement activities
40
Cost
72.24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11015750FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Nurse Practitioner CurrentSince Jun 13, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 7, 2022 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 7, 2022 Accepting new patients

Locations

4500 Pleasant Hill Rd
Kissimmee, FL 34746
Phone (407) 944-9030

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: gsustachemercado338931@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717804800000",
    "number": "1013671569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PLEASANT HILL RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462724",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PLEASANT HILL RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462724",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1222 S Orange Ave",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061215",
            "country_code": "US",
            "telephone_number": "321-841-7700",
            "fax_number": "321-841-7799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUSTACHE MERCADO",
        "first_name": "GABRIEL",
        "middle_name": "JOSUE",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-29",
        "last_updated": "2024-06-08",
        "certification_date": "2024-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11015750",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11015750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11015750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.