John Andrew Merriam, PA-S

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9115803 Issued in FL

Practice address

125 Alma Blvd
Merritt Island, FL 32953-4345

Phone

(201) 654-6397

NPI assigned

Jan 29, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Merit-based Incentive Payment System (MIPS)

Final score

87.66 of 100Reported as group

Quality

73.72

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Perry Orthopedics LLC

  • Orthopaedic Surgery Physician
  • Melbourne, FL
  • NPI 1467930826
  Medicare reassignment
• National Health Rehabilitation LLC

  • Physical Medicine & Rehabilitation Physician
  • Edgewater, NJ
  • NPI 1780080218

  FL

  Medicare reassignment

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1801487137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-500-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 ALMA BLVD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329534345",
            "telephone_number": "201-654-6397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 W Hibiscus Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329012615",
            "country_code": "US",
            "telephone_number": "321-500-5633",
            "fax_number": "321-617-5633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERRIAM",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9115803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melodie'S Place LLC
• Amado Jose Mendoza, P.T.
• Josefina Mendoza, P.T.
• Meridian Teleradiology, Inc.
• Merit Medical Care LLC
• Merritt Island ASC LLC
• Merritt Island Chiropractic, LLC
• Merritt Island Conscious Sedation
• Merritt Island Foot & Ankle Inc
• Merritt Island Health Care Associates LLC

• Surgical Physician Assistant in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.