Active NPI
Corey Merrill
- Physician Assistant
- Glenview, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2401 Ravine Way
Suite 200
Glenview, IL 60025-7645 - Phone
- (847) 998-5680
- NPI assigned
- Dec 29, 2014
- Last updated
- Feb 10, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2401 Ravine Way
Suite 200
Glenview, IL 60025-7645
Mailing address
900 Rand Rd
Sutie 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976
Other practice location 1
9850 Genesee Ave Ste 320
LA Jolla, CA 92037-1208
Phone (858) 554-1212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Regents of the University of California
Practice addresses (Care Compare)
200 W Arbor Dr
San Diego, CA 92103-1910
Phone (858) 657-7000
3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855
3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212
4142 Adams Ave
Suite 102
San Diego, CA 92116-2593
Phone (858) 617-0717
6915 Flanders Dr
Suite D
San Diego, CA 92121-2987
Phone (240) 778-6164
9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000
9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (858) 657-7000
9400 Campus Point Dr
La Jolla, CA 92093-1350
Phone (858) 657-7000
9415 Campus Point Dr
La Jolla, CA 92093-1350
Phone (858) 657-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| UC San Diego Health - Rancho Family Medical Group | Past | Accepting new patients | |
| Regents of the University of California | Past | Accepting new patients | |
| Regents of the University of California Ucsd Head and Neck Surgery | Past | Accepting new patients |
Locations
9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
Organizations & group practices 9
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.
-
- Orthopaedic Surgery Physician
- San Diego, CA
- NPI 1225130677
-
- Family Medicine Physician
- San Diego, CA
- NPI 1578672184
-
dba In-Patient Medical Group
- Pulmonary Disease Physician
- Encinitas, CA
- NPI 1841387214
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
-
dba Ucsd Medical Center Pharmacy
- Pharmacy
- San Diego, CA
- NPI 1598786576
-
- Otolaryngology Physician
- San Diego, CA
- NPI 1679509962
-
- Multi-Specialty Clinic/Center
- Temecula, CA
- NPI 1003385071
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba UCSD Medical Center
- General Acute Care Hospital
- San Diego, CA
- NPI 1184722779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1386032308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 RAND RD",
"address_2": "SUTIE 300",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600162359",
"telephone_number": "847-324-3976",
"fax_number": "847-929-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 RAVINE WAY",
"address_2": "SUITE 200",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600257645",
"telephone_number": "847-998-5680"
}
],
"practiceLocations": [
{
"address_1": "9850 Genesee Ave Ste 320",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920371208",
"country_code": "US",
"telephone_number": "858-554-1212",
"fax_number": "858-795-1195",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MERRILL",
"first_name": "COREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-29",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.