Individual provider Active NPI

Merrick Maynard Tsai, MD, FNP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Highland, CA
National Provider Identifier
1366012791
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95017885 Issued in CA
Practice address
28839 Lemon St
Highland, CA 92346-5386
Phone
(909) 742-9889
Fax
(909) 498-1635
NPI assigned
Jun 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11020654 FL
Family Nurse Practitioner 363LF0000X NP95017885 CA
Family Nurse Practitioner 363LF0000X 857119 NV
Family Nurse Practitioner 363LF0000X 243315 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 857119 NV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 243315 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11020654 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95017885 CA Primary

Addresses

Primary practice location

28839 Lemon St
Highland, CA 92346-5386

Mailing address

28839 Lemon St
Highland, CA 92346-5386
Phone (909) 742-9889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
APRN11020654FLMDFamily Nurse Practitioner
857119NVMDFamily Nurse Practitioner
243315AZMDPsychiatric/Mental Health Nurse Practitioner
NP95017885CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cerebral Medical Group, a Professional Corporation PastSince Aug 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: merrick.tsai@wsmc1.eclinicaldirectplus.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1366012791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28839 LEMON ST",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923465386",
            "telephone_number": "909-742-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28839 LEMON ST",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923465386",
            "telephone_number": "909-742-9889",
            "fax_number": "909-498-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAI",
        "first_name": "MERRICK",
        "middle_name": "MAYNARD",
        "name_prefix": "Dr.",
        "credential": "MD, FNP-BC, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020654",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95017885",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "857119",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "243315",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "857119",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "243315",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11020654",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95017885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.