Lisa Mercado, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5988 Issued in SC

Practice address

170 Village Center Blvd
Myrtle Beach, SC 29579-6618

Phone

(843) 449-5848

Fax

(843) 692-0908

NPI assigned

Jul 8, 2011

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774656000000",
    "number": "1467749556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 VILLAGE CENTER BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796618",
            "telephone_number": "843-449-5848",
            "fax_number": "843-692-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 VILLAGE CENTER BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796618",
            "telephone_number": "843-449-5848",
            "fax_number": "843-692-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "LISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2026-03-28",
        "certification_date": "2026-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0147471",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilse Mejia, MD
• Melissa Melroy, LMSW
• Jessica Sue Mendelsohn, CRNA
• Joseph J Menn, DPM
• Michelle Ann Mennecke-Smith, RN
• Nicholas Francis Mercaldo
• Amanda Mercer, MS, LPC, LCPC
• Mercy Care
• Phillip Meredith, O.D.
• Merhi Eye Clinic

• Physician Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.