| Marcellus Family Medicine Pllc | |
|
28 1/2 E Main St Marcellus NY 13108-1226 | |
| (315) 673-9926 | |
| Not Available |
| Full Name | Marcellus Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 28 1/2 E Main St, Marcellus, New York |
| Authorized Official Name and Position | Andrew J Merritt (OWNER) |
| Authorized Official Contact | 3156739926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marcellus Family Medicine Pllc 28 1/2 E Main St Marcellus NY 13108-1226 Ph: () - | Marcellus Family Medicine Pllc 28 1/2 E Main St Marcellus NY 13108-1226 Ph: (315) 673-9926 |
| NPI Number | 1245427640 |
|---|---|
| Provider Enumeration Date | 09/29/2007 |
| Last Update Date | 09/29/2007 |
| Medicare PECOS PAC ID | 6406938646 |
|---|---|
| Medicare Enrollment ID | O20080128000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245427640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 127430 (New York) | Primary |
| Provider Name | John A Alley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598727554 PECOS PAC ID: 2769466093 Enrollment ID: I20040615001004 |
| Provider Name | Andrew J Merritt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548291248 PECOS PAC ID: 3375527682 Enrollment ID: I20080128000438 |
| Provider Name | Katherine B Halstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528670593 PECOS PAC ID: 2567873193 Enrollment ID: I20201202002672 |
| Provider Name | Reina C Baizan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619548047 PECOS PAC ID: 8820492093 Enrollment ID: I20210810002394 |
| Provider Name | Mikela Elizabeth Sorenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205506714 PECOS PAC ID: 3274905021 Enrollment ID: I20230223002728 |
| Provider Name | Erika Flemmig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386321875 PECOS PAC ID: 9638523863 Enrollment ID: I20230921003255 |
Marcellus Medical Group Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1/2 Orange St, Marcellus, NY 13108 Phone: 317-673-1529 Fax: 315-673-2434 |