Active NPI
Gary Scott Merrill, DO
- Psychiatry Physician
- Troy, NY
National Provider Identifier
1346357001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 192673
- Practice address
- 2215 Burdett Ave
Behavioral Health Dept
Troy, NY 12180-2466 - Phone
- (518) 271-3300
- NPI assigned
- Aug 25, 2006
- Last updated
- Jun 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 192673 | NY | Primary |
Addresses
Primary practice location
2215 Burdett Ave
Behavioral Health Dept
Troy, NY 12180-2466
Mailing address
PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | payer.credentialing@sphp.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Hospital of Troy, New York | Psychiatry | Current | Accepting new patients |
Locations
2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300
Interoperability endpoints
- gmerrill789105@direct.trinity-health.org
- payer.credentialing@sphp.com
Organizations & group practices 1
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": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1346357001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14890",
"city": "ALBANY",
"state": "NY",
"postal_code": "122124890",
"telephone_number": "518-525-5634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 BURDETT AVE",
"address_2": "BEHAVIORAL HEALTH DEPT",
"city": "TROY",
"state": "NY",
"postal_code": "121802466",
"telephone_number": "518-271-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "GARY",
"middle_name": "SCOTT",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "192673",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "payer.credentialing@sphp.com",
"affiliation": "N",
"endpointDescription": "SPHP Payer Credentialing",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "2215 Burdett Ave",
"address_2": "Behavioral Health Dept",
"city": "Troy",
"state": "NY",
"country_code": "US",
"postal_code": "121802466",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.