NPIMap

Individual provider Active NPI

Andrew D Merliss, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Lincoln, NE
National Provider Identifier
1174637516
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
21982 Issued in NE
Practice address
1600 S 48TH St
Suite 600
Lincoln, NE 68506-1275
Phone
(402) 483-3333
Fax
(402) 483-3297
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 21982 NE
Clinical Cardiac Electrophysiology Physician 207RC0001X 21982 NE Primary

Addresses

Primary practice location

1600 S 48TH St
Suite 600
Lincoln, NE 68506-1275

Mailing address

1600 S 48TH St
Suite 600
Lincoln, NE 68506-1275
Phone (402) 483-3333

Other identifiers 4

IdentifierTypeStateIssuer
208450304MedicaidMO
0567065MedicaidIA
47084496100MedicaidNE
100450730AMedicaidKS

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21982NEMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carrington Health Center Past Accepting new patients
Carrington Health Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1174637516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "address_2": "SUITE 600",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061275",
            "telephone_number": "402-483-3333",
            "fax_number": "402-483-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S 48TH ST",
            "address_2": "SUITE 600",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685061275",
            "telephone_number": "402-483-3333",
            "fax_number": "402-483-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERLISS",
        "first_name": "ANDREW",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NE",
            "license": "21982",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NE",
            "license": "21982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208450304",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0567065",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47084496100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100450730A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.