Individual provider Active NPI

Christopher D. Mercado, M.D.

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1629377379
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15352 Issued in NV
Practice address
4855 Blue Diamond Rd Ste 220
Las Vegas, NV 89139-7602
Phone
(702) 616-5801
NPI assigned
Mar 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 15352 NV Primary

Addresses

Primary practice location

4855 Blue Diamond Rd Ste 220
Las Vegas, NV 89139-7602

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (702) 616-5801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805001321 NV Practitioner - Family Practice 3971736083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nevada School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Las Vegas Medical Group LLCGroup PAC ID 6800118522, 51 clinicians

Practice addresses (Care Compare)

866 Seven Hills Dr
Suite 201
Henderson, NV 89052-4376
Phone (702) 551-2079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15352NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Medical Group LLC Family Medicine CurrentSince Sep 11, 2023 Accepting new patients
Dignity Health Past Accepting new patients

Locations

1389 Galleria Dr
Ste 100
Henderson, NV 89014
Phone (725) 333-8400

866 Seven Hills Dr
Ste 201
Henderson, NV 89052
Phone (702) 430-5333

Organizations & group practices 2

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": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1629377379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "702-616-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 BLUE DIAMOND RD STE 220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397602",
            "telephone_number": "702-616-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "CHRISTOPHER",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "15352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.