Individual provider Active NPI

Rafael L Mercado, DDS

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1376633479
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17101 Issued in TX
Practice address
1931 NW Military Hwy
Suite 225
San Antonio, TX 78213-2153
Phone
(210) 732-4570
NPI assigned
Oct 13, 2006
Last updated
Oct 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17101 TX Primary

Addresses

Primary practice location

1931 NW Military Hwy
Suite 225
San Antonio, TX 78213-2153

Mailing address

1931 NW Military Hwy
Suite 225
San Antonio, TX 78213-2153
Phone (210) 732-4570

Other identifiers 4

IdentifierTypeStateIssuer
1306173554OtherTXTYPE 2 BUSINESS NPI
180123502MedicaidTX
1376774851OtherTXNPI
136341809MedicaidTX

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17101TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Castle Hills Family Dental General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1376633479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1931 NW MILITARY HWY",
            "address_2": "SUITE 225",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132153",
            "telephone_number": "210-732-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 NW MILITARY HWY",
            "address_2": "SUITE 225",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132153",
            "telephone_number": "210-732-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "RAFAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 BUSINESS NPI",
            "identifier": "1306173554",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180123502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376774851",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136341809",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.