Individual provider Active NPI

Matthew Ephraim Mercado

  • Student in an Organized Health Care Education/Training Program
  • Nashville, TN
National Provider Identifier
1104786169
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2004 Hayes St Ste 200
Nashville, TN 37203-2689
Phone
(615) 324-1600
NPI assigned
Nov 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2004 Hayes St Ste 200
Nashville, TN 37203-2689

Mailing address

908 Division St Apt 1322
Nashville, TN 37203-5782
Phone (956) 499-8008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20260317003545 TN Practitioner - Physician Assistant 0840774964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Sports Medicine and Orthopaedic Center PLCGroup PAC ID 8729009634, 90 clinicians

Practice addresses (Care Compare)

2004 Hayes St
Suite 200
Nashville, TN 37203-2689
Phone (615) 324-1600

Hospital & facility affiliations

  • Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Sports Medicine and Orthopaedic Center, PLC CurrentSince Feb 3, 2026 Accepting new patients
Elite Sports Medicine and Orthopaedic Center, PLC CurrentSince Feb 3, 2026 Accepting new patients

Locations

2004 Hayes St
Ste 200
Nashville, TN 37203
Phone (615) 284-2000

356 24th Ave N
Ste 200
Nashville, TN 37203
Phone (615) 329-2225

Organizations & group practices 2

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.

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": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1104786169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 DIVISION ST APT 1322",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035782",
            "telephone_number": "956-499-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 HAYES ST STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032689",
            "telephone_number": "615-324-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "MATTHEW",
        "middle_name": "EPHRAIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.