Individual provider Active NPI

Mercedes Grace Laurencin, M.D. M.P.H.

  • Family Medicine Physician
  • Santa Cruz, CA
National Provider Identifier
1750401055
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G51038 Issued in CA
Practice address
634 Frederick St
Santa Cruz, CA 95062-2203
Phone
(831) 421-9535
Fax
(831) 421-9290
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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 G51038 CA Primary

Addresses

Primary practice location

634 Frederick St
Santa Cruz, CA 95062-2203

Mailing address

634 Frederick St
Santa Cruz, CA 95062-2203
Phone (831) 421-9535

Other identifiers 1

IdentifierTypeStateIssuer
00G510381OtherMEDICARE IDENTIFICATION NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050330000620 CA Practitioner - Family PracticePractitioner - Hospice/Palliative Care 2769438985 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
Boston University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

634 Frederick St
Santa Cruz, CA 95062-2203
Phone (831) 421-9535

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Personal Physicians Inc Family Medicine CurrentSince May 1, 2005 Accepting new patients
County of Santa Clara Family Medicine Current Accepting new patients
County of Santa Clara CurrentSince Nov 7, 2018 Accepting new patients
County of Santa Clara CurrentSince Nov 7, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Nov 7, 2018 Accepting new patients
County of Santa Clara CurrentSince Nov 7, 2018 Accepting new patients
Santa Cruz Medical Clinic, Inc Family Medicine Past Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

750 S Bascom Ave
#1112
San Jose, CA 95128

634 Frederick St
Santa Cruz, CA 95062
Phone (408) 426-8310

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: mercedes.laurencin.1@14345.direct.athenahealth.com
  • Direct secure messaging: mlaurencin101727@hisp.ehr.sutterhealth.org
  • Direct secure messaging: daldana91655@santaclaravalley.direct-ci.net

Organizations & group practices 8

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 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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1750401055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622203",
            "telephone_number": "831-421-9535",
            "fax_number": "831-421-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 FREDERICK ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622203",
            "telephone_number": "831-421-9535",
            "fax_number": "831-421-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENCIN",
        "first_name": "MERCEDES",
        "middle_name": "GRACE",
        "credential": "M.D. M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G51038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IDENTIFICATION NUMBER",
            "identifier": "00G510381",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.