Individual provider Active NPI

Meredith Clare Merucci, PA-C

  • Physician Assistant
  • Farmington, MI
National Provider Identifier
1164014668
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
23133 Orchard Lake Rd Ste 201
Farmington, MI 48336-3279
Phone
(248) 476-4850
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

23133 Orchard Lake Rd Ste 201
Farmington, MI 48336-3279

Mailing address

1650 Bagley St Unit 6
Detroit, MI 48216-2235
Phone (248) 882-1801

Other names 1

  • Meredith Green Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

23133 Orchard Lake Rd
Suite 201
Farmington, MI 48336-3268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Farmington Dermatologists PC CurrentSince Sep 3, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1164014668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 BAGLEY ST UNIT 6",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482162235",
            "telephone_number": "248-882-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23133 ORCHARD LAKE RD STE 201",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363279",
            "telephone_number": "248-476-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERUCCI",
        "first_name": "MEREDITH",
        "middle_name": "CLARE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "GREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Farmington, MI

Sources for this page

Verify at the official NPI Registry.