Individual provider Active NPI

Gerald Merritt IV, DPM

  • Foot & Ankle Surgery Podiatrist
  • Glendale, AZ
National Provider Identifier
1275067654
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD-001153 Issued in AZ
Practice address
18301 N 79TH Ave
Glendale, AZ 85308-8463
Phone
(623) 544-9090
NPI assigned
Apr 12, 2017
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD-001153 AZ Primary

Addresses

Primary practice location

18301 N 79TH Ave
Glendale, AZ 85308-8463

Mailing address

875 N Greenfield Rd Ste 105
Gilbert, AZ 85234-5044
Phone (623) 544-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230215002515 AZ Practitioner - Podiatry 0749611176 Reassigns benefits to 1 organization
I20250130003980 TX Practitioner - Podiatry 0749611176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Neville and Associates PAGroup PAC ID 4688647498, 5 clinicians

Practice addresses (Care Compare)

1120 Medical Plaza Dr
Suite 180
Shenandoah, TX 77380-3250
Phone (281) 364-9041

18301 N 79TH Ave
Suite F168
Glendale, AZ 85308-6045
Phone (623) 544-9090

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue59
Removal of skin lesions12
Removal of nail tissue179
Removal or shaving of skin growth51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3071TXMDBehavioral Analyst
POD-001153AZMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Neville & Associates PA Podiatrist CurrentSince Mar 1, 2025 Accepting new patients

Locations

1120 Medical Plaza Dr
Ste 180
Shenandoah, TX 77380
Phone (281) 364-9041

Interoperability endpoints

  • Direct secure messaging: gerald.merritt.1@11939.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDBCD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1275067654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N GREENFIELD RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345044",
            "telephone_number": "623-544-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088463",
            "telephone_number": "623-544-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "GERALD",
        "name_suffix": "IV",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "POD-001153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.