Organization Active NPI

Merriderm Dermatology PLLC

  • Medical Specialty Clinic/Center
  • Flushing, NY
National Provider Identifier
1255775227
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
266027 Issued in NY
Legal business name
MERRIDERM DERMATOLOGY PLLC
Practice address
3644 Main St # 2NDFL
Flushing, NY 11354-4143
Phone
(347) 732-0690
Fax
(347) 732-0691
NPI assigned
Apr 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Wenhong ZhouNPI 1952558504
Title
President/Owner
Phone
(917) 770-7908

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 266027 NY Primary

Addresses

Primary practice location

3644 Main St # 2NDFL
Flushing, NY 11354-4143

Mailing address

3644 Main St # 2NDFL
Flushing, NY 11354-4143
Phone (347) 732-0690

Other identifiers 1

IdentifierTypeStateIssuer
03509437MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131108000441 NY Part B Supplier - Clinic/Group Practice 0143455667 Receives reassigned benefits from 1 practitioner
Practice locations: Flushing, NY

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
33D2052825Merriderm Dermatology PLLC3644 Main Street, 2ND Floor, Flushing, NY 11354Provider-performed microscopyJan 17, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHCACD

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": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1255775227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3644 MAIN ST # 2NDFL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544143",
            "telephone_number": "347-732-0690",
            "fax_number": "347-732-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 MAIN ST # 2NDFL",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544143",
            "telephone_number": "347-732-0690",
            "fax_number": "347-732-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIDERM DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "ZHOU",
        "authorized_official_first_name": "WENHONG",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "917-770-7908"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "266027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03509437",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.