Individual provider Active NPI

Ivan Alexandro Mercado, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Francisco, CA
National Provider Identifier
1093456170
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E6179 Issued in CA
Practice address
4150 Clement St
San Francisco, CA 94121-1563
Phone
(415) 221-4810
NPI assigned
Apr 5, 2022
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E6179 CA Primary

Addresses

Primary practice location

4150 Clement St
San Francisco, CA 94121-1563

Mailing address

7620 Cutler Ave
Orland, CA 95963-9696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251110000758 CA Practitioner - Podiatry 2860982618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey Demian IncGroup PAC ID 4880944339, 27 clinicians

Practice addresses (Care Compare)

7612 Adwen St
Downey, CA 90241-4419
Phone (562) 291-1994

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue13
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E6179CAMDFoot & Ankle Surgery Podiatrist
6179CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey Demian Inc Foot & Ankle Surgery CurrentSince Oct 15, 2025 Accepting new patients

Locations

17215 Studebaker Rd
Ste 108
Cerritos, CA 90703
Phone (310) 750-4511

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1093456170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 CUTLER AVE",
            "city": "ORLAND",
            "state": "CA",
            "postal_code": "959639696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "IVAN",
        "middle_name": "ALEXANDRO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E6179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.