Individual provider Active NPI

Elizabeth Mercado, FNP-BC

  • Family Nurse Practitioner
  • Beaverton, OR
National Provider Identifier
1245978709
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202112146NP-PP Issued in OR
Practice address
4855 SW Western Ave
Beaverton, OR 97005-3460
Phone
(503) 813-2000
NPI assigned
May 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202112146NP-PP OR Primary

Addresses

Primary practice location

4855 SW Western Ave
Beaverton, OR 97005-3460

Mailing address

4855 SW Western Ave
Beaverton, OR 97005-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221205001374 OR Practitioner - Nurse Practitioner 0840669420 Reassigns benefits to 1 organization
I20221205001480 WA Practitioner - Nurse Practitioner 0840669420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

4855 SW Western Ave
Beaverton, OR 97005-3460
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 22, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 22, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 22, 2022 Accepting new patients

Locations

4855 SW Western Ave
Beaverton, OR 97005
Phone (503) 626-4148

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

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": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1245978709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 SW WESTERN AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 SW WESTERN AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053460",
            "telephone_number": "503-813-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202112146NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.