Individual provider Active NPI

Jeancarlo Javier Mercado-Rivera

  • Certified Registered Nurse Anesthetist
  • Lutz, FL
National Provider Identifier
1407630908
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11032407 Issued in FL
Practice address
14832 Normans Cay Cir Apt 102
Lutz, FL 33559-3502
Phone
(939) 216-2631
NPI assigned
Aug 24, 2023
Last updated
Jul 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11032407 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

14832 Normans Cay Cir Apt 102
Lutz, FL 33559-3502

Mailing address

14832 Normans Cay Cir Apt 102
Lutz, FL 33559-3502

Other practice location 1

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (813) 745-4673

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605004106 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466994488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (954) 393-5000

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (954) 939-5000

900 Carillon Pkwy
Suite 205
Saint Petersburg, FL 33716-1108
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11032407FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince May 1, 2024 Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince May 1, 2024 Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2140 W 68th St
Hialeah, FL 33016
Phone (305) 332-2065

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1407630908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14832 NORMANS CAY CIR APT 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14832 NORMANS CAY CIR APT 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593502",
            "telephone_number": "939-216-2631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12902 Usf Magnolia Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336129416",
            "country_code": "US",
            "telephone_number": "813-745-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCADO-RIVERA",
        "first_name": "JEANCARLO",
        "middle_name": "JAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11032407",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.