Organization Active NPI

Digestive Disease Associates, LLP

  • Gastroenterology Physician
  • Rochester, NY
National Provider Identifier
1104834126
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
177994 Issued in NY
Legal business name
DIGESTIVE DISEASE ASSOCIATES, LLP
Practice address
1561 Long Pond Rd
Ste 110
Rochester, NY 14626
Phone
(585) 723-1510
Fax
(585) 723-1518
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
Dr. Karl T Mersich, MD
Title
Dr Partner
Phone
(585) 723-1510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 177994 NY Primary

Addresses

Primary practice location

1561 Long Pond Rd
Ste 110
Rochester, NY 14626

Mailing address

1561 Long Pond Rd
Ste 110
Rochester, NY 14626
Phone (585) 723-1510

Other identifiers 1

IdentifierTypeStateIssuer
01252744MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070102000179 NY Part B Supplier - Clinic/Group Practice 1658371406 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory
Tax ID family
Digestive Disease Associates LLP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

97 Canal Landing Blvd
Ste 4
Rochester, NY 14626
Phone (585) 723-1510

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1104834126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "STE 110",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14626",
            "telephone_number": "585-723-1510",
            "fax_number": "585-723-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 LONG POND RD",
            "address_2": "STE 110",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14626",
            "telephone_number": "585-723-1510",
            "fax_number": "585-723-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASE ASSOCIATES, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "MERSICH",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DR PARTNER",
        "authorized_official_telephone_number": "585-723-1510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "177994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01252744",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.