NPIMap

Individual provider Active NPI

Luis Mercado, PA-C

  • Medical Physician Assistant
  • Turlock, CA
National Provider Identifier
1508332305
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA56630 Issued in CA
Practice address
3650 Geer Rd Ste B
Turlock, CA 95382-1148
Phone
(209) 633-3014
NPI assigned
Oct 18, 2018
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA56630 CA Primary
Adult Medicine Physician 207QA0505X PA56630 CA

Addresses

Primary practice location

3650 Geer Rd Ste B
Turlock, CA 95382-1148

Mailing address

3650 Geer Rd Ste B
Turlock, CA 95382-1148
Phone (209) 633-3014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191203001448 CA Practitioner - Physician Assistant 3476986530 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clinic Services of California Medical Group IncGroup PAC ID 7810209715, 65 clinicians
Kind Clinic Physician Assistant Owned ApcGroup PAC ID 1850832510, 3 clinicians

Practice addresses (Care Compare)

1235 W Vine St
Suite 20
Lodi, CA 95240-5144
Phone (209) 334-3411

350 S Oak Ave
Oakdale, CA 95361-3519
Phone (209) 847-3012

3650 Geer Rd
Suite a
Turlock, CA 95382-1148
Phone (209) 633-3014

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA56630CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians Emergency Medicine of Southern California, P.C. Multi-Specialty CurrentSince Feb 5, 2026 Accepting new patients
Cep America-California Multi-Specialty CurrentSince Nov 1, 2019 Accepting new patients
Cep America - California Multi-Specialty CurrentSince Nov 1, 2019 Accepting new patients
Golden State Health Care Inc. Multi-Specialty PastSince Oct 1, 2016 Accepting new patients

Locations

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

350 S Oak Ave
Oakdale, CA 95361
Phone (209) 847-3011

Organizations & group practices 9

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1508332305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 GEER RD STE B",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953821148",
            "telephone_number": "209-633-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 GEER RD STE B",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953821148",
            "telephone_number": "209-633-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "LUIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-18",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA56630",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "PA56630",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.