Individual provider Active NPI

Neloufa R Merrill, MD

  • Pediatrics Physician
  • Bakersfield, CA
National Provider Identifier
1548335920
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A39996 Issued in CA
Practice address
525 Roberts LN
Bakersfield, CA 93308-4799
Phone
(661) 392-7850
Fax
(661) 215-2349
NPI assigned
Nov 21, 2006
Last updated
Jan 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A39996 CA Primary

Addresses

Primary practice location

525 Roberts LN
Bakersfield, CA 93308-4799

Mailing address

659 S Central Valley Hwy
Shafter, CA 93263-2790
Phone (661) 459-1900

Other identifiers 1

IdentifierTypeStateIssuer
ZZT11802FMedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623002376 CA Practitioner - Pediatric Medicine 2769793330 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39996CAMDPharmacist
A39996CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Family Health Current Accepting new patients
Omni Family Health CurrentSince Apr 18, 2015 Accepting new patients
Omni Family Health CurrentSince Apr 18, 2015 Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Omni Family Health Past Accepting new patients
San Joaquin Community Hospital Past Accepting new patients

Locations

1014 Calloway Dr
Bldg F
Bakersfield, CA 93312

4900 California Ave
Ste 400B
Bakersfield, CA 93309
Phone (661) 630-7046

525 Roberts Ln
Bakersfield, CA 93308
Phone (661) 392-7850

277 E Front St
Buttonwillow, CA 93206
Phone (661) 630-7381

659 S Central Valley Hwy
Shafter, CA 93263
Phone (661) 459-1913

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: neloufa.merrill.p1@direct.omnifamilyhealth.nextgenshare.com

Organizations & group practices 6

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1548335920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S CENTRAL VALLEY HWY",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632790",
            "telephone_number": "661-459-1900",
            "fax_number": "661-459-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROBERTS LN",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933084799",
            "telephone_number": "661-392-7850",
            "fax_number": "661-215-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "NELOUFA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A39996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT11802F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.