Individual provider Active NPI

Demetri J Merianos, MD

  • Pediatric Surgery Physician
  • New York, NY
National Provider Identifier
1902953854
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
271264 Issued in NY
Practice address
525 E 68TH St
New York, NY 10065-4870
Phone
(215) 738-0423
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X C54566 CA
Pediatric Surgery Physician 2086S0120X 271264 NY Primary

Addresses

Primary practice location

525 E 68TH St
New York, NY 10065-4870

Mailing address

525 E 68TH St # 209
New York, NY 10065-4870
Phone (646) 962-2599

Other practice location 1

506 6th St
Brooklyn, NY 11215-3609
Phone (718) 780-5856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131017001346 NY Practitioner - General SurgeryPractitioner - Pediatric Medicine 5496989816 Reassigns benefits to 3 organizations
I20260527001497 NJ Practitioner - General Surgery 5496989816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers New Jersey Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 W Gilbert St
Tinton Falls, NJ 07701-4948

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C54566CAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Aug 4, 2024 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince May 15, 2023 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Sep 1, 2013 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince May 15, 2023 Accepting new patients
Weill Cornell University Medical College Past Accepting new patients
Weill Medical College of Cornell Past Accepting new patients
Cornell University Medical College Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

5634 Main St
Fl 1
Flushing, NY 11355
Phone (718) 670-2468

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

525 E 68th St
#209
New York, NY 10065
Phone (646) 962-2599

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: dmerianos840267@nychhc.direct-ci.com
  • Direct secure messaging: dem9110@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1902953854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST # 209",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "646-962-2599",
            "fax_number": "212-746-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "215-738-0423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 6th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112153609",
            "country_code": "US",
            "telephone_number": "718-780-5856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERIANOS",
        "first_name": "DEMETRI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "C54566",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "271264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.