Individual provider Active NPI

Bernadette De Guzman Mercado, NP

  • Family Nurse Practitioner
  • Valencia, CA
National Provider Identifier
1659042596
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95016969 Issued in CA
Practice address
23428 Magic Mountain Pkwy Apt 1404
Valencia, CA 91355-2187
Phone
(224) 247-8277
NPI assigned
Sep 21, 2021
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95016969 CA Primary

Addresses

Primary practice location

23428 Magic Mountain Pkwy Apt 1404
Valencia, CA 91355-2187

Mailing address

23428 Magic Mountain Pkwy Apt 1404
Valencia, CA 91355-2187
Phone (224) 247-8277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220502002047 CA Practitioner - Nurse Practitioner 1658768148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Proyecto del Barrio IncGroup PAC ID 3476546227, shared by 6 NPIs, 27 clinicians

Practice addresses (Care Compare)

18250 Roscoe Blvd
Suite 200
Northridge, CA 91325-4226
Phone (818) 721-4800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95016969CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minghsun Liu, M.D., PC CurrentSince Apr 25, 2022 Accepting new patients

Locations

11103 Venice Blvd
Los Angeles, CA 90034
Phone (310) 734-8526

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1659042596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23428 MAGIC MOUNTAIN PKWY APT 1404",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552187",
            "telephone_number": "224-247-8277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23428 MAGIC MOUNTAIN PKWY APT 1404",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913552187",
            "telephone_number": "224-247-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "BERNADETTE",
        "middle_name": "DE GUZMAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.