NPIMap

Individual provider Active NPI

Matthew M Merrell, MD

  • Urology Physician
  • Daytona Beach, FL
National Provider Identifier
1346291259
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME80554 Issued in FL
Practice address
545 Health Blvd
Daytona Beach, FL 32114-1493
Phone
(386) 239-8500
NPI assigned
May 15, 2006
Last updated
Dec 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME80554 FL Primary

Addresses

Primary practice location

545 Health Blvd
Daytona Beach, FL 32114-1493

Mailing address

12109 County Road 103
Oxford, FL 34484-2951
Phone (352) 205-8981

Other identifiers 1

IdentifierTypeStateIssuer
35978OtherBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000107 FL Practitioner - Urology 1951486141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

545 Health Blvd
Daytona Beach, FL 32114-1493
Phone (386) 239-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.09 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
80.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Institute, LLC Urology CurrentSince Apr 1, 2014 Accepting new patients
Atlantic Surgery Center Inc CurrentSince Mar 1, 2020 Accepting new patients
Advanced Urology Institute, LLC Urology CurrentSince Apr 1, 2014 Accepting new patients
Advanced Urology Institute LLC Urology Past Accepting new patients

Locations

545 Health Blvd
Daytona Beach, FL 32114
Phone (386) 239-8500

609 W Highland Blvd
Inverness, FL 34452
Phone (352) 726-9707

506 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 427-9554

1061 Medical Center Dr
Ste 300
Orange City, FL 32763
Phone (386) 427-9554

12109 County Road 103
Oxford, FL 34484
Phone (352) 205-8981

61 Memorial Medical Pkwy
Ste 3803
Palm Coast, FL 32164
Phone (386) 445-8530

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://1e97bf46-5f98-4384-bf8d-cffaf9bb8f4c.gastro.prod.fhir.ema-api.com/fhir/r4/
  • FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida
  • Direct secure messaging: matthewmerrell@aui.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1346291259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 COUNTY ROAD 103",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344842951",
            "telephone_number": "352-205-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 HEALTH BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141493",
            "telephone_number": "386-239-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME80554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "35978",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.