Individual provider Active NPI

Niki Nicole Mercado, LMSW

  • Social Worker
  • Waterloo, IA
National Provider Identifier
1396444378
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
117764 Issued in IA
Practice address
3261 University Ave
Waterloo, IA 50701-2051
Phone
(800) 531-4236
Fax
(319) 483-6661
NPI assigned
Feb 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 192168 AK
Social Worker 104100000X 117764 IA Primary

Addresses

Primary practice location

3261 University Ave
Waterloo, IA 50701-2051

Mailing address

159 4TH St
Evansdale, IA 50707-2141
Phone (907) 978-9203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, AK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240823002998 IA Practitioner - Clinical Social Worker 4981143765 Reassigns benefits to 1 organization
Practice locations: Waterloo, IA
I20241220003656 AK Practitioner - Clinical Social Worker 4981143765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greater Works Caring CenterGroup PAC ID 0648706358, 3 clinicians

Practice addresses (Care Compare)

3401 Peger Rd
Suite C
Fairbanks, AK 99709-5488
Phone (907) 374-7076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
192168AKMDSocial Worker
117764IAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Works Caring Center CurrentSince Oct 31, 2024 Accepting new patients
Heart and Solutions CurrentSince Jul 10, 2024 Accepting new patients
Nest of Healing, LLC Current Accepting new patients

Locations

626 G Ave
Grundy Center, IA 50638
Phone (319) 239-8522

1542 Flammang Dr
Waterloo, IA 50702
Phone (319) 493-7040

3261 University Ave
Waterloo, IA 50701
Phone (319) 239-8522

227 E San Marnan Dr
Waterloo, IA 50702
Phone (563) 500-9993

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": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1396444378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 4TH ST",
            "city": "EVANSDALE",
            "state": "IA",
            "postal_code": "507072141",
            "telephone_number": "907-978-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012051",
            "telephone_number": "800-531-4236",
            "fax_number": "319-483-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "NIKI",
        "middle_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AK",
            "license": "192168",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "117764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.