Individual provider Active NPI

Merin Varghese Somu, PA-C

  • Physician Assistant
  • New Hyde Park, NY
National Provider Identifier
1689206781
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone
(516) 495-0151
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Surgical Physician Assistant 363AS0400X 024862-01 NY

Addresses

Primary practice location

27005 76TH Ave
New Hyde Park, NY 11040-1402

Mailing address

888 Surrey Dr
East Meadow, NY 11554-4727
Phone (516) 495-0151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200928002727 NY Practitioner - Physician Assistant 8729407515 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024862NYMDPediatric Physical Therapist
024862-01NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2022 Accepting new patients
Chenango Memorial Hospital, Inc. Physician Assistant Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1689206781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 SURREY DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544727",
            "telephone_number": "516-495-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "516-495-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMU",
        "first_name": "MERIN",
        "middle_name": "VARGHESE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "024862-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.