Matthew Mercado

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW122255 Issued in CA

Practice address

12830 Hesperia Rd Ste CD
Victorville, CA 92395-7788

Phone

(760) 684-8999

NPI assigned

May 5, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Pacific Heritage Medical Group IncGroup PAC ID 7517284029, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pacific Heritage Medical Group Inc

  • Geriatric Psychiatry Physician
  • Westlake Village, CA
  • NPI 1467899450
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1851701320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12830 HESPERIA RD STE CD&E",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12830 HESPERIA RD STE CD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957788",
            "telephone_number": "760-684-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW122255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skye Mendoza
• Yarely Mendoza
• Maria Menegazzo
• Jennifer Renae Menezes
• Jennifer Effie Mercado
• Diane Carolyn Mercer
• Mercy Air Service, Inc.
• Sandra Elizabeth Merida
• Tammy Lajaun Merritt
• Elsa Mesina, MSBA RDN, RN

• Clinical Social Worker in Victorville, CA
• Providers in Victorville, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.