Organization Active NPI

Anthony P Merza MD P C

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1265556054
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
060005186 Issued in IL
Legal business name
ANTHONY P MERZA MD P C
Practice address
5145 N California Ave
Chicago, IL 60625-3661
Phone
(773) 275-8811
Fax
(773) 282-2120
NPI assigned
Mar 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Authorized official

Name
Dr. Anthony Pera Merza, M.D.NPI 1780709337
Title
President
Phone
(773) 275-8811

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 060005186 IL Primary

Addresses

Primary practice location

5145 N California Ave
Chicago, IL 60625-3661

Mailing address

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 275-8811

Other identifiers 4

IdentifierTypeStateIssuer
036067060MedicaidIL
100004712OtherILRAIL ROAD MEDICARE
0031603386OtherILBLUE CROSS BLUE SHIELD
K02230OtherILMEDICARE PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040122000396 IL Part B Supplier - Clinic/Group Practice 7416859368 Receives reassigned benefits from 1 practitioner
Practice locations: Skokie, IL; Chicago, IL

National Provider Directory

National Provider Directory

Locations

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

18440 Thompson Ct
Ste 203
Tinley Park, IL 60477

Practitioners & affiliated clinicians

Practitioners 2

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": "1174176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1265556054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-275-8811",
            "fax_number": "773-282-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-275-8811",
            "fax_number": "773-282-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY P MERZA MD P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-18",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "MERZA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "PERA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-275-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "060005186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067060",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "100004712",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0031603386",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "K02230",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.