Brian Longhurst Merrill, DO is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Balsam Lake, Wisconsin. His current practice location is
100 Polk County Plz Ste 180, Balsam Lake, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 485-8876.
Brian Longhurst Merrill is licensed to practice in Wisconsin (license number 1851-321) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1982648929.
Physician's Profile
| Full Name | Brian Longhurst Merrill |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 100 Polk County Plz Ste 180, Balsam Lake, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1982648929
- Provider Enumeration Date: 06/16/2006
- Last Update Date: 03/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 3072575802
- Enrollment ID: I20230221001821
Medical Identifiers
Medical identifiers for Brian Longhurst Merrill such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982648929 | NPI | - | NPPES |
| 751650 | Other | UT | DMBA |
| 200521603BM2 | Other | UT | EMIA |
| 79126 | Other | UT | PEHP |
| 200521603 | Other | UT | FIRSTHEALTH |
| 49931531200001 | Other | UT | BCBS OF UT |
| 107012431102 | Other | UT | SELECTHEALTH |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 73041 (Minnesota) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4993153 (Utah) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 1851-321 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brian Longhurst Merrill allows following entities to bill medicare on his behalf.
| Entity Name | Southwestern Mental Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487654562
PECOS PAC ID: 7012816812
Enrollment ID: O20031231000148 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brian Longhurst Merrill is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Brian Longhurst Merrill, DO
1300 N 500 E, Suite 330,
Logan, UT 84341-2408
Ph: (435) 716-5790 | Brian Longhurst Merrill, DO
100 Polk County Plz Ste 180,
Balsam Lake, WI 54810-8009
Ph: (715) 485-8876 |
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