Kim Alexis Mercado Edralin, PT
Physical Therapist · San Jose
- Medicare standing
- 1 flag on the record
- Listed below.
- Plans that list them
- Not verified
- Not the same as out of network.
- Office
- 1
On the public record
- Medicare does not list them as allowed to order and refer
Offices
1 location
Plan participation
Not verified
We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Kim Alexis Mercado Edralin’s office at (408) 274-0888 to ask if they take your plan before you enroll.
Original Medicare doctor bills
$6,777
Medicare paid this office $6,777 for 37 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Therapy procedure using functional activities | 37 | $1,901 | $31 |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 36 | $1,289 | $21 |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 36 | $1,130 | $19 |
| Therapy procedure using manual technique, each 15 minutes | 37 | $1,106 | $18 |
| Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 23 | $285 | $8 |
Who their Medicare patients are
37 Original Medicare patients in 2024. Average age 75 · Health risk score 1.05. Above the middle of the specialty; the typical physical therapist in private practice clinician is at 1.03.
Conditions among them: High blood pressure 75% · Diabetes 43%.
The office billed $22,980, Medicare allowed $9,218 and paid $6,777; for 290 services of 7 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 37 | 290 | 75 | 1.05 | $22,980 | $6,777 |
| 2023 | 73 | 810 | 74 | 1.00 | $62,840 | $19,985 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 6 services
| Therapy procedure using functional activities | 73 | $5,991 | $36 |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 73 | $4,029 | $24 |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 73 | $3,553 | $21 |
| Therapy procedure using manual technique, each 15 minutes | 73 | $3,302 | $19 |
| Evaluation for physical therapy, typically 20 minutes | 15 | $1,478 | $99 |
| Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 47 | $923 | $9 |
Medicaid work
$125 in 2024
Medicaid paid $125 for 332 billed services this clinician did in 2024, up to 40 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES | 17 | $51 |
| Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities | 16 | $26 |
| Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes | 124 | $24 |
| THERAPEUTIC EXERCISES | 41 | $24 |
| UNLISTED THERAPEUTIC PROCEDURE SPECIFY | 134 | $0 |
| 2024 | 332 | 5 | 40 | $125 |
| 2023 | 438 | 4 | 35 | $27 |
See the largest Medicaid services in earlier years
2023
| MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES | 48 | $27 |
| THERAPEUTIC EXERCISES | 64 | $0 |
| Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities | 47 | $0 |
| Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes | 279 | $0 |
Professional record
- NPI
- 1922790658
- Licence
- CA 303917
More record details
- Sole proprietor
- No
- Taxonomy
- Federal specialty code 225100000X (225100000X)
- Mailing address
- 2680 S White Rd Ste 200, San Jose, CA, 95148
- NPI first listed
- 2023-05-22
- NPI last updated
- 2023-05-22
- NPI record certified
- 2023-05-22
This is when the NPI record was last certified, not a medical board exam.
Extra NPI addresses: 1436 California Cir, Milpitas, CA, 95035