Active NPI
Jeffrey D Merrill, MD
- Neonatal-Perinatal Medicine Physician
- Oakland, CA
National Provider Identifier
1720017254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- A46081
- Practice address
- 747 52ND St
Neonatology - 3Rd Floor
Oakland, CA 94609-1809 - Phone
- (510) 428-5282
- Fax
- (510) 450-5823
- NPI assigned
- Jun 30, 2006
- Last updated
- Aug 6, 2007
- 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 |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | A46081 | CA | Primary |
Addresses
Primary practice location
747 52ND St
Neonatology - 3Rd Floor
Oakland, CA 94609-1809
Mailing address
747 52ND St
Neonatology - 3Rd Floor
Oakland, CA 94609-1809
Phone (510) 428-5282
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6934706 | Medicaid | NJ | |
| 0015555570001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A46081 | CA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Bay Newborn Specialists, Inc. | Neonatal-Perinatal Medicine | Past | Accepting new patients |
Interoperability endpoints
- jmerrill16220@alamedahs.direct-ci.com
- jmerrill38999@hisp.ehr.sutterhealth.org
Organizations & group practices 1
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.
-
- Neonatal-Perinatal Medicine Physician
- Oakland, CA
- NPI 1043375561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1720017254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 52ND ST",
"address_2": "NEONATOLOGY - 3RD FLOOR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946091809",
"telephone_number": "510-428-5282",
"fax_number": "510-450-5823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "747 52ND ST",
"address_2": "NEONATOLOGY - 3RD FLOOR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946091809",
"telephone_number": "510-428-5282",
"fax_number": "510-450-5823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "JEFFREY",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "A46081",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6934706",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015555570001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.