Individual provider Active NPI

Jett Joseph Mercer, M.D.

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1063428381
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
P1107 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-4000
NPI assigned
Jul 31, 2006
Last updated
Jun 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01057038A IN
Anesthesiology Physician 207L00000X P1107 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

7703 Floyd Curl Dr
Mc7977
San Antonio, TX 78229-3901
Phone (210) 450-9000

Other identifiers 2

IdentifierTypeStateIssuer
296762204OtherTXCSHCN
296762203MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225001084 SD Practitioner - Anesthesiology 6103089651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

216 Anamaria Dr
Rapid City, SD 57701-7366
Phone (605) 721-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01057038AINMDAnesthesiology Physician
P1107TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Surgical Hospital, LLC CurrentSince Jan 1, 2022 Accepting new patients
Black Hills Surgical Hospital, LLC CurrentSince Jan 1, 2022 Accepting new patients
Black Hills Surgical Hospital, LLC Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients

Locations

1868 Lombardy Dr
Rapid City, SD 57703
Phone (605) 721-4900

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1063428381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "MC7977",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-450-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "JETT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01057038A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P1107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "296762204",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296762203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.