Organization Active NPI

Mercy Retirement and Care Center

  • Skilled Nursing Facility
  • Oakland, CA
National Provider Identifier
1225029366
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
020000237 Issued in CA
Legal business name
MERCY RETIREMENT AND CARE CENTER
Practice address
3431 Foothill Blvd
Oakland, CA 94601-3129
Phone
(510) 534-8540
Fax
(510) 261-4516
NPI assigned
Oct 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Ms. Adriene Iverson
Title
Ceo
Phone
(510) 769-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 020000237 CA Primary

Addresses

Primary practice location

3431 Foothill Blvd
Oakland, CA 94601-3129

Mailing address

3431 Foothill Blvd
Oakland, CA 94601-3129
Phone (510) 534-8540

Other identifiers 1

IdentifierTypeStateIssuer
LTC55189FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090718000013 CA Part A Provider - Skilled Nursing Facility 8729130976 Practice locations: Oakland, CA

Skilled nursing facility certification: CCN 555189

Legal name
MERCY RETIREMENT AND CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 17, 1985
Last certification
Feb 13, 2025
Beds
59
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 11, 1894 in CA
Enrollment address
3431 Foothill Blvd
Oakland, CA 94601-3172
Nursing home name
MERCY RETIREMENT & CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mercy Retirement & Care CenterCCN 555189
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 17, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5950.7 residents per day on average
Penalties (3 years)
1Fines totaling $16,675

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0643822Mercy Retirement & Care Center3431 Foothill Blvd, Oakland, CA 94601Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elder Care Alliance Organization, Oakland, CA Non-profit 5% Or Greater Direct Ownership Interest Jan 17, 1985 100%
Mark Krueger Individual W-2 Managing EmployeeAdministrator Nov 9, 2016
Geraldine McGrath Individual Corporate DirectorBoard Member Dec 1, 2020
Raelynne Benham-Dwyer Individual W-2 Managing EmployeeInterim Health Care Services Adm Aug 11, 2022
Blaine Lyons Individual W-2 Managing EmployeeAdministrator May 11, 2017
Robin Evitts Individual Corporate OfficerChief Financial Officer May 6, 2019
Nicole L Foreman Individual W-2 Managing EmployeeAdministrator Sep 16, 2019
Marjorie Balley Individual Corporate OfficerCfo Nov 9, 2013
Lynn Katzmann Individual Corporate DirectorBoard Member Dec 1, 2012
Adriene M Iverson Individual Corporate OfficerPresident/Ceo Apr 1, 2015
Christine Whelan Individual Corporate DirectorBoard Member Dec 1, 2011
Rahul S Joglekar Individual Corporate DirectorBoard Member May 19, 2009

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1225029366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 FOOTHILL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013129",
            "telephone_number": "510-534-8540",
            "fax_number": "510-261-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 FOOTHILL BLVD",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013129",
            "telephone_number": "510-534-8540",
            "fax_number": "510-261-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY RETIREMENT AND CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "ADRIENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-769-2700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "020000237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55189F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.