Individual provider Active NPI

Natalie Ann Mercado, PA-C

  • Medical Physician Assistant
  • Dallas, GA
National Provider Identifier
1669779278
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105515 Issued in FL
Practice address
850 Charles Hardy Pkwy
Dallas, GA 30157-3163
Phone
(770) 336-8888
Fax
(770) 336-7406
NPI assigned
Feb 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105515 FL Primary

Addresses

Primary practice location

850 Charles Hardy Pkwy
Dallas, GA 30157-3163

Mailing address

4651 Van Dyke Rd
Lutz, FL 33558-4880
Phone (813) 321-1786

Other identifiers 1

IdentifierTypeStateIssuer
009326300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20251103000248 GA Practitioner - Physician Assistant 9931342193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1008
Phone (770) 422-5557

850 Charles Hardy Pkwy
Dallas, GA 30157-3163
Phone (770) 336-8888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105515FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Georgia PC CurrentSince Nov 1, 2025 Accepting new patients
Dermatopathology Lab of Skin Cancer Specialists, P.C. CurrentSince Nov 1, 2025 Accepting new patients
Douglas K Pierce MD PA PastSince Jan 8, 2023 Accepting new patients

Locations

850 Charles Hardy Pkwy
Dallas, GA 30157
Phone (770) 336-8888

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

Interoperability endpoints

  • Direct secure messaging: nmercado734458@direct.hopkinsmedicine.org

Organizations & group practices 3

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": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1669779278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584880",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 CHARLES HARDY PKWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301573163",
            "telephone_number": "770-336-8888",
            "fax_number": "770-336-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "NATALIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-16",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009326300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.