Paolo Petilla Mercado, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209018353 Issued in IL

Practice address

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Phone

(847) 360-2860

Fax

(847) 625-6057

NPI assigned

Nov 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, WI2 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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waukegan Clinic CorpGroup PAC ID 4284631086, 60 clinicians

Vituity-Wisconsin HM SCGroup PAC ID 4880056126, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vista Medical Center East Hospital, Waukegan, IL, CCN 140084

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
• Direct secure messaging: pmercado597440@direct.froedtert.com

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.

• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289
  Medicare reassignment Care Compare group NPD
• Vituity-Wisconsin HM SC

  • Hospitalist Physician
  • Pleasant Prairie, WI
  • NPI 1679265912
  Medicare reassignment Care Compare group NPD
• Vital Health Partners LLC

  • Hospitalist Physician
  • Miami Lakes, FL
  • NPI 1043101207

  IL

  Medicare reassignment
• Oncology Hematology Associates of Northern Illinois, LTD

  • Hematology & Oncology Physician
  • Gurnee, IL
  • NPI 1093142135
  NPD

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

• Waukegan Illinois Hospital Company LLC

  • General Acute Care Hospital
  • Waukegan, IL
  • NPI 1639120694
  Care Compare affiliation

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1447728183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3076 NICKLAUS LN",
            "city": "WADSWORTH",
            "state": "IL",
            "postal_code": "600838944",
            "telephone_number": "224-388-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-2860",
            "fax_number": "847-625-6057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Red Oak Ln",
            "address_purpose": "LOCATION",
            "city": "Lindenhurst",
            "state": "IL",
            "postal_code": "600464998",
            "country_code": "US",
            "telephone_number": "847-356-4746",
            "fax_number": "847-356-4737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "PAOLO",
        "middle_name": "PETILLA",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-12",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018353",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13217-33",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alison Merant
• Catherine Margaret Merlock, MS, CCC, SLP/L, MA
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• Mi'Asia Oriann Metcalf
• Michelle Metcalf
• Metrosmiles - Waukegan Dental PC

• Family Nurse Practitioner in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.