NPIMap

Individual provider Active NPI

Eugene K Merecki, MD

  • Family Medicine Physician
  • Malta, NY
National Provider Identifier
1720070808
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
180894 Issued in NY
Practice address
6 Medical Park Dr
Suite 208
Malta, NY 12020-5051
Phone
(518) 899-2632
Fax
(518) 899-6418
NPI assigned
Aug 16, 2005
Reactivated
Apr 13, 2006
Last updated
Jul 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 180894 NY Primary

Addresses

Primary practice location

6 Medical Park Dr
Suite 208
Malta, NY 12020-5051

Mailing address

6 Medical Park Dr
Suite 208
Malta, NY 12020-5051
Phone (518) 899-2632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000128 NY Practitioner - Family Practice 2264597053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6 Medical Park Dr
Suite 208
Malta, NY 12020-5053
Phone (518) 899-2632

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
180894NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Family Medicine,PLLC Family Medicine CurrentSince Jan 8, 2009 Accepting new patients
Eugene K. Merecki, MD PC CurrentSince Jan 8, 2009 Accepting new patients

Locations

100 Saratoga Village Blvd
Ste 34
Malta, NY 12020
Phone (518) 899-2632

6 Medical Park Dr
Ste 208
Malta, NY 12020
Phone (518) 899-2632

Interoperability endpoints

  • Direct secure messaging: emerecki@maltafamilymedicine.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 31

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1720070808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MEDICAL PARK DR",
            "address_2": "SUITE 208",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120205051",
            "telephone_number": "518-899-2632",
            "fax_number": "518-899-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEDICAL PARK DR",
            "address_2": "SUITE 208",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120205051",
            "telephone_number": "518-899-2632",
            "fax_number": "518-899-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERECKI",
        "first_name": "EUGENE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2014-07-17",
        "deactivation_date": "2006-04-10",
        "reactivation_date": "2006-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "180894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malta, NY

Sources for this page

Verify at the official NPI Registry.