Active NPI
Neil Jetrho Sobrevinas Mercado, BSN, RN
- Certified Registered Nurse Anesthetist
- South Pasadena, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 95002685
- Practice address
- 1417 Oneonta KNL
South Pasadena, CA 91030-4611 - Phone
- (650) 863-4586
- NPI assigned
- Jul 24, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95136514 | CA | |
| Certified Registered Nurse Anesthetist | 367500000X | 95002685 | CA | Primary |
Addresses
Primary practice location
1417 Oneonta KNL
South Pasadena, CA 91030-4611
Mailing address
1417 Oneonta KNL
South Pasadena, CA 91030-4611
Phone (650) 863-4586
Other practice location 1
4867 W Sunset Blvd
Los Angeles, CA 90027-5969
Phone (833) 574-2273
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1301 20TH St
Suite 280
Santa Monica, CA 90404-2053
Phone (310) 829-6789
4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011
4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784
4867 W Sunset Blvd
Los Angeles, CA 90027-5969
Phone (323) 783-4011
Hospital & facility affiliations
- Kaiser Foundation Hospital - Los Angeles
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95136514 | CA | MD | Registered Nurse |
| 95002685 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
4867 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-7920
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
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.
-
- Certified Registered Nurse Anesthetist
- Santa Monica, CA
- NPI 1639604747
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- San Diego, CA
- NPI 1225060742
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1821143777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1942038658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 ONEONTA KNL",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910304611",
"telephone_number": "650-863-4586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 ONEONTA KNL",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910304611",
"telephone_number": "650-863-4586"
}
],
"practiceLocations": [
{
"address_1": "4867 W Sunset Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900275969",
"country_code": "US",
"telephone_number": "833-574-2273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MERCADO",
"first_name": "NEIL JETRHO",
"middle_name": "SOBREVINAS",
"name_prefix": "Mr.",
"credential": "BSN, RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-24",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95136514",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95002685",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1417 Oneonta Knl",
"city": "South Pasadena",
"state": "CA",
"country_code": "US",
"postal_code": "910304611",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.