Individual provider Active NPI

Michael Lee Merrin, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Santa Barbara, CA
National Provider Identifier
1194719633
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
G18945 Issued in CA
Practice address
1919 State Street
Suite 302
Santa Barbara, CA 93101-2430
Phone
(805) 563-9814
Fax
(805) 563-9838
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X G18945 CA Primary

Addresses

Primary practice location

1919 State Street
Suite 302
Santa Barbara, CA 93101-2430

Mailing address

PO Box 50706
Santa Barbara, CA 93150-0706
Phone (805) 963-3757

Other identifiers 1

IdentifierTypeStateIssuer
00G189450MedicaidCA

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
G18945CAMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1194719633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50706",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931500706",
            "telephone_number": "805-963-3757",
            "fax_number": "805-564-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 STATE STREET",
            "address_2": "SUITE 302",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931012430",
            "telephone_number": "805-563-9814",
            "fax_number": "805-563-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIN",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CA",
            "license": "G18945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G189450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.