Individual provider Active NPI

Nancy B Merrell, M.D.

  • Gastroenterology Physician
  • Cooperstown, NY
National Provider Identifier
1710943246
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
132789 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326-1301
Phone
(607) 547-3760
Fax
(607) 547-6995
NPI assigned
Apr 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 132789 NY
Gastroenterology Physician 207RG0100X 132789 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326-1301

Mailing address

PO Box 725
Cooperstown, NY 13326-0725
Phone (607) 547-3760

Other identifiers 1

IdentifierTypeStateIssuer
01162761MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100128000530 NY Practitioner - Gastroenterology 4385786300

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132789NYMDGastroenterology Physician

Interoperability endpoints

  • Direct secure messaging: nmerrell5591@bassett.direct-ci.net

NPI Registry JSON

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1710943246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-3760",
            "fax_number": "607-547-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3760",
            "fax_number": "607-547-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRELL",
        "first_name": "NANCY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "132789",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "132789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01162761",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.