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KEVIN H MERKLEY M.D.
NPI 1043256811
Ophthalmology in Galveston, TX

Active since June 21, 2006PECOS EnrolledAccepts Medicare Assignment
74.96/100
CMS Quality Rating
700 UNIVERSITY BLVD, GALVESTON, TX 77555(409) 747-5400(409) 747-5402 Get Directions Write a Review

NPPES record last updated: June 16, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kevin H Merkley M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN H MERKLEY M.D. (NPI 1043256811) is an individual ophthalmology provider in Galveston, Texas, licensed in Utah (186738-1205) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Texas Medical Branch Galveston, and is a graduate of University Of Utah School Of Medicine (1987).

NPPES Registry Identity

NPI1043256811
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameKEVIN H MERKLEYCredential: M.D.
Location Address700 UNIVERSITY BLVDGalveston, TX 77555-1106
Mailing Address301 University BlvdGalveston, TX 77555-1106 · (409) 747-5400 · Fax (409) 747-5402
Phone(409) 747-5400
Fax(409) 747-5402
Sole ProprietorNo
Medical School CMSUniversity Of Utah School Of MedicineGraduated 1987
Enumeration DateJune 21, 2006
Last NPPES UpdateJune 16, 2026
NPPES CertifiedJune 16, 2026
✔ NPI 1043256811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in UT · 186738-1205
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOphthalmology · Uveitis and Ocular Inflammatory DiseaseTaxonomy 207WX0108X · License N8222 (TX)
Also ListedOphthalmology · Cornea and External Diseases SpecialistTaxonomy 207WX0120X · License N8222 (TX)
700 UNIVERSITY BLVD, Galveston, TX 77555
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kevin H Merkley M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961430897
PECOS Enrollment IDI20050924000228, I20120413000501
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kevin Merkley reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Utmb Faculty Group Practice
0.4 mi
General Practice
301 UNIVERSITY BLVD
Galveston, TX 77555
  • Reassigned Medicare billing, Texas enrollment
  • 2,222 clinicians in this Medicare group
NPI 1942241146 (409) 772-2222
University Of Utah Adult Services
1,230 mi
Orthopaedic Surgery
9385 S SNOWBIRD CENTER DR
Sandy, UT 84092
  • Reassigned Medicare billing, Utah enrollment
  • 2,620 clinicians in this Medicare group
NPI 1851904247 (801) 587-7109

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
43 services39 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
31 services29 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
16 services16 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
13 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Texas Medical Branch Galveston

Acute Care Hospitals · Galveston, TX
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number450018
Location301 University BoulevardGalveston, TX 77555 · Galveston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77555 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$131.16 typical visit price
range $57.19 – $173.07
Typical copayment $32.79 (range $14.29 – $43.26)
Most-billed visit code 99204
Established Patient
$71.32 typical visit price
range $18.45 – $141.36
Typical copayment $17.83 (range $4.61 – $35.34)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.96/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.77
Promoting Interoperability94
Improvement Activities40
Cost47.75

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HAROLD SCOTT PINE MD
Otolaryngology (Pediatric Otolaryngology)
700 UNIVERSITY BLVD
GALVESTON, TX 77555
Galveston County (281) 338-0829
TAYLOR ELDORA MITCHELL PA-C
Physician Assistant
700 UNIVERSITY BLVD
GALVESTON, TX 77555
Galveston County (281) 338-0829
YUSIF HAJIYEV MD
Otolaryngology (Pediatric Otolaryngology)
700 UNIVERSITY BLVD
GALVESTON, TX 77555
Galveston County (281) 557-0829
DR. SORIN GHEORGHE BECA MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
700 UNIVERSITY BLVD, STARK DIABETES CENTER
GALVESTON, TX 77555
Galveston County (409) 747-5800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Merkley's NPI number?

The NPI number for Kevin Merkley is 1043256811. It was assigned to this individual provider in the NPPES registry on June 21, 2006.

Where is Kevin Merkley located?

Kevin Merkley practices at 700 University Blvd, Galveston, TX 77555. The listed phone number is (409) 747-5400.

What is Kevin Merkley's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Kevin Merkley enrolled in Medicare?

Yes. Kevin Merkley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kevin Merkley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Merkley reassigns Medicare benefits to 2 organizations: Utmb Faculty Group Practice (Galveston, TX) and University Of Utah Adult Services (Sandy, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Merkley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Merkley accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 9 other insurers list Kevin Merkley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kevin Merkley affiliated with any hospitals?

According to CMS data, Kevin Merkley is affiliated with University Of Texas Medical Branch Galveston.

When was this NPI record last updated?

The NPPES record for Kevin Merkley was last updated on June 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.