Individual provider Active NPI

Amanda Mercado, CRNA

  • Certified Registered Nurse Anesthetist
  • Las Vegas, NV
National Provider Identifier
1114463312
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
843554 Issued in NV
Practice address
7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395
Phone
(702) 878-0070
Fax
(702) 209-2064
NPI assigned
Jan 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 843554 NV Primary
Certified Registered Nurse Anesthetist 367500000X 4704275264 MI

Addresses

Primary practice location

7160 Rafael Rivera Way Ste 210
Las Vegas, NV 89113-5395

Mailing address

PO Box 840857
Dallas, TX 75284-0857
Phone (725) 204-4632

Other practice location 1

370 Norborne Ave
Dearborn Heights, MI 48127-3758
Phone (313) 575-2763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.25 of 100Reported as group
Quality
74.41
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704275264MIMDCertified Registered Nurse Anesthetist
843554NVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Nurse Anesthetist, Certified Registered CurrentSince Jan 24, 2017 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Nov 7, 2018 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jan 24, 2017 Accepting new patients
Arizona Anesthesia Consultants, Inc. Nurse Anesthetist, Certified Registered PastSince Nov 1, 2021 Accepting new patients

Locations

7915 Solutions Ctr Dr
Chicago, IL 60677

18100 Oakwood Blvd
Ste 100
Dearborn, MI 48124
Phone (313) 240-7668

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600

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": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1114463312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840857",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840857",
            "telephone_number": "725-204-4632",
            "fax_number": "702-805-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7160 RAFAEL RIVERA WAY STE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891135395",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 Norborne Ave",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481273758",
            "country_code": "US",
            "telephone_number": "313-575-2763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "843554",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704275264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.