Active NPI
Merrill Jay Mirman, D.O.
- Pain Medicine Physician
- Media, PA
National Provider Identifier
1760478697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- OS002340L
- Practice address
- 14 Bonnie LN
Media, PA 19063-5606 - Phone
- (610) 361-7878
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP024664L | PA | |
| Pain Medicine Physician | 208VP0000X | OS002340L | PA | Primary |
Addresses
Primary practice location
14 Bonnie LN
Media, PA 19063-5606
Mailing address
14 Bonnie LN
Media, PA 19063-5606
Phone (610) 361-7878
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP024664L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1760478697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 BONNIE LN",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635606",
"telephone_number": "610-361-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 BONNIE LN",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635606",
"telephone_number": "610-361-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRMAN",
"first_name": "MERRILL",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-26",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP024664L",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "PA",
"license": "OS002340L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.