Active NPI
Joseph Alphonse Merola, PA
- Physician Assistant
- De Witt, NY
National Provider Identifier
1194786277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 007463-1
- Practice address
- 3709 Erie Blvd
Dewitt, NY 13214-2227 - Phone
- (315) 251-2244
- Fax
- (315) 251-2240
- NPI assigned
- Mar 29, 2006
- Last updated
- Mar 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 007463 | NY | |
| Physician Assistant | 363A00000X | 007463-1 | NY | Primary |
Addresses
Primary practice location
3709 Erie Blvd
Dewitt, NY 13214-2227
Mailing address
304 Genesee St
Chittenango, NY 13037-1707
Phone (315) 687-6467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02508501 | Medicaid | NY |
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, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007463-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489536000000",
"number": "1194786277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 GENESEE ST",
"city": "CHITTENANGO",
"state": "NY",
"postal_code": "130371707",
"telephone_number": "315-687-6467",
"fax_number": "315-251-2240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3709 ERIE BLVD",
"city": "DEWITT",
"state": "NY",
"postal_code": "132142227",
"telephone_number": "315-251-2244",
"fax_number": "315-251-2240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEROLA",
"first_name": "JOSEPH",
"middle_name": "ALPHONSE",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-29",
"last_updated": "2017-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "007463",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "007463-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02508501",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in De Witt, NY
- Christy Marvin, PHARM D
- Simran Marwah, DDS
- Mary Fox Dba Basic Baby (Basic Baby)
- Cynthia Marie Massara, OTR
- Menorah Park Group Residents
- Michael Frederick Miller, D.M.D
- Miriam Paley-Williams Licensed Marriage and Family Therapist PLLC
- Danielle Lynn Motyka, MSPT
- Neal F Marshall, Optometrist, PLLC (Kavanagh & Marshall)
- Mary Sciarrino Nicolais
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.