Organization Active NPI

Richard F Mercado DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Lauderdale Lakes, FL
National Provider Identifier
1356508683
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2250 Issued in FL
Legal business name
RICHARD F MERCADO DPM PA
Practice address
4900 W Oakland Park Blvd
Suite 107
Lauderdale Lakes, FL 33313-7500
Phone
(919) 425-1565
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

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

Authorized official

Name
Dr. Richard F Mercado, DPMNPI 1427038538
Title
President
Phone
(919) 425-1565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X PO2250 FL
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X PO2250 FL
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X PO2250 FL Primary
Durable Medical Equipment & Medical Supplies 332B00000X PO2250 FL

Addresses

Primary practice location

4900 W Oakland Park Blvd
Suite 107
Lauderdale Lakes, FL 33313-7500

Mailing address

4900 W Oakland Park Blvd
Suite 107
Lauderdale Lakes, FL 33313-7500
Phone (919) 425-1565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080814000511 FL Part B Supplier - Clinic/Group Practice 7012082720 Receives reassigned benefits from 1 practitioner
Practice locations: Lauderdale Lakes, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1356508683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 W OAKLAND PARK BLVD",
            "address_2": "SUITE 107",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137500",
            "telephone_number": "919-425-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 W OAKLAND PARK BLVD",
            "address_2": "SUITE 107",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137500",
            "telephone_number": "919-425-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD F MERCADO DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "MERCADO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-425-1565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "PO2250",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2250",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2250",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PO2250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.