Individual provider Active NPI

Herold J Merisier, MD

  • Family Medicine Physician
  • Plantation, FL
National Provider Identifier
1356337497
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME74841 Issued in FL
Practice address
480 N State Road 7
Plantation, FL 33317
Phone
(954) 791-9580
Fax
(954) 797-0473
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME74841 FL Primary

Addresses

Primary practice location

480 N State Road 7
Plantation, FL 33317

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other identifiers 1

IdentifierTypeStateIssuer
258082900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address herold.merisier.1@29601.direct.athenahealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070824000618 FL Practitioner - Family Practice 0042302762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

480 N State Rd
Suite 7
Plantation, FL 33317-2834
Phone (954) 791-9580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME74841FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Family Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

7593 W Boynton Beach Blvd
Ste 140
Boynton Beach, FL 33437
Phone (561) 354-4840

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

480 N State Road 7
Plantation, FL 33317
Phone (954) 791-9580

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1356337497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 N STATE ROAD 7",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33317",
            "telephone_number": "954-791-9580",
            "fax_number": "954-797-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERISIER",
        "first_name": "HEROLD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258082900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "herold.merisier.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "480 N State Road 7",
            "city": "Plantation",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.