Individual provider Active NPI

Sergio Mercado, MD

  • Family Medicine Physician
  • Leesburg, FL
National Provider Identifier
1730123902
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME165262 Issued in FL
Practice address
4700 That St
Leesburg, FL 34748-9723
Phone
(352) 326-5281
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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 ME165262 FL Primary

Addresses

Primary practice location

4700 That St
Leesburg, FL 34748-9723

Mailing address

410 Fern Dr
Leesburg, FL 34748-7008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041210000287 IL Practitioner - Family Practice 5294636577 Reassigns benefits to 1 organization
I20240304000095 FL Practitioner - Family Practice 5294636577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Aegis Medical Group LLCGroup PAC ID 8022324862, 20 clinicians

Practice addresses (Care Compare)

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

4700 That St
Leesburg, FL 34748-9723
Phone (352) 326-3281

Hospital & facility affiliations

  • Pinnacle Home Care of the Villages Inc Home health agency, The Villages, FL, CCN 109702
  • Lake Centre Home Care, LLC Home health agency, Leesburg, FL, CCN 108416
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME165262FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
To Your Health of Lake County Inc CurrentSince Feb 5, 2024 Accepting new patients
Aegis Medical Group LLC CurrentSince Feb 5, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients

Locations

4700 That St
Leesburg, FL 34748
Phone (352) 326-5281

410 Fern Dr
Leesburg, FL 34748
Phone (352) 218-8200

18550 US Highway 441
Mount Dora, FL 32757
Phone (352) 735-3755

4685 N Highway 19A
Mount Dora, FL 32757
Phone (352) 483-0900

Dept 5777
Carol Stream, IL 60122

1302 N Main St
Sandwich, IL 60548
Phone (815) 486-8484

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDHAD

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1730123902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 FERN DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 THAT ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489723",
            "telephone_number": "352-326-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "SERGIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME165262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.