Individual provider Active NPI

Martha Merz, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1629661400
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007544 Issued in IL
Practice address
4646 N Marine Dr
Chicago, IL 60640-5759
Phone
(773) 878-8700
NPI assigned
Feb 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007544 IL Primary

Addresses

Primary practice location

4646 N Marine Dr
Chicago, IL 60640-5759

Mailing address

4646 N Marine Dr
Chicago, IL 60640-5759
Phone (773) 878-8700

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chicago

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123001923 CO Practitioner - Physician Assistant 6800285396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care ColoradoGroup PAC ID 7214295989, 23 clinicians

Practice addresses (Care Compare)

110 E Boardwalk
Fort Collins, CO 80525-3047
Phone (970) 821-1500

2555 E 13TH St
Suite 110
Loveland, CO 80537-5134
Phone (970) 820-4264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085007544ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Colorado CurrentSince Feb 1, 2024 Accepting new patients
Banner Urgent Care Colorado CurrentSince Feb 1, 2024 Accepting new patients

Locations

2001 70th Ave
Ste 110
Greeley, CO 80634
Phone (970) 378-4155

2555 E 13th St
Ste 110
Loveland, CO 80537
Phone (970) 461-6140

Organizations & group practices 2

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": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1629661400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-878-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-878-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERZ",
        "first_name": "MARTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "address_1": "4646 N Marine Dr",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.