Organization Active NPI

Maria Corazon Meris MD Inc

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1235666744
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A56490 Issued in CA
Legal business name
MARIA CORAZON MERIS MD INC
Practice address
3400 W Ball Rd Ste 102
Anaheim, CA 92804-3735
Phone
(714) 816-0088
Fax
(714) 816-0005
NPI assigned
May 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. CHI Meris
Title
Office Manager/Administrator
Phone
(714) 816-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A56490 CA Primary

Addresses

Primary practice location

3400 W Ball Rd Ste 102
Anaheim, CA 92804-3735

Mailing address

3400 W. Ball Road, Suite 102
Anaheim, CA 92804-3735
Phone (714) 816-0088

Other identifiers 1

IdentifierTypeStateIssuer
00A564900MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170615001633 CA Part B Supplier - Clinic/Group Practice 5597033589 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0983636Maria Corazon Meris MD Inc3400 W Ball Rd Ste 102, Anaheim, CA 92804Certificate of waiverFeb 26, 2027

National Provider Directory

National Provider Directory

Locations

3400 W Ball Rd
Ste 102
Anaheim, CA 92804
Phone (714) 816-0088

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": "1494806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1235666744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W. BALL ROAD, SUITE 102",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043735",
            "telephone_number": "714-816-0088",
            "fax_number": "714-816-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD STE 102",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043735",
            "telephone_number": "714-816-0088",
            "fax_number": "714-816-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA CORAZON MERIS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MERIS",
        "authorized_official_first_name": "CHI",
        "authorized_official_title_or_position": "OFFICE MANAGER/ADMINISTRATOR",
        "authorized_official_telephone_number": "714-816-0088",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A56490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A564900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.