Individual provider Active NPI

Jordan Magtoto Mercado, FNP-C

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1871308833
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95033828 Issued in CA
Practice address
110 N Lincoln Ave Ste 100
Corona, CA 92882-1853
Phone
(833) 867-8462
NPI assigned
Feb 7, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 95033828 CA Primary

Addresses

Primary practice location

110 N Lincoln Ave Ste 100
Corona, CA 92882-1853

Mailing address

110 N Lincoln Ave Ste 100
Corona, CA 92882-1853
Phone (951) 396-7341

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
I20250603001836 CA Practitioner - Nurse Practitioner 0446769210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optima Health CorpGroup PAC ID 3779911466, 32 clinicians

Practice addresses (Care Compare)

3634 Elizabeth St
Riverside, CA 92506-2506
Phone (951) 788-0008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95033828CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optima Health Corp CurrentSince Apr 21, 2025 Accepting new patients
Skilled Provider Network CurrentSince Mar 8, 2026 Accepting new patients

Locations

110 N Lincoln Ave
Ste 100
Corona, CA 92882
Phone (833) 867-8462

3634 Elizabeth St
Riverside, CA 92506
Phone (951) 341-8930

Interoperability endpoints

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

Organizations & group practices 2

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": "1738886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1871308833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N LINCOLN AVE STE 100",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928821853",
            "telephone_number": "951-396-7341",
            "fax_number": "951-240-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N LINCOLN AVE STE 100",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928821853",
            "telephone_number": "833-867-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCADO",
        "first_name": "JORDAN",
        "middle_name": "MAGTOTO",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-07",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95033828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.