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DR. FANTAYE MERID M.D.
NPI 1104012921
Family Medicine in Wilmington, CA

Active since September 16, 2007PECOS Enrolled
200 E ANAHEIM ST, WILMINGTON, CA 90744(310) 522-8700 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 14, 2026, Jan 13, 2023, Nov 4, 2021 (3 updates tracked since 2021).

About Dr. Fantaye Merid M.d. NPPES

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

DR. FANTAYE MERID M.D. (NPI 1104012921) is an individual family medicine provider in Wilmington, California, licensed in California (A94075) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104012921
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. FANTAYE MERIDCredential: M.D.
Location Address200 E ANAHEIM STWilmington, CA 90744-4516
Mailing Address200 E Anaheim StWilmington, CA 90744-4516 · (310) 522-8700
Phone(310) 522-8700
Sole ProprietorNo
Enumeration DateSeptember 16, 2007
Last NPPES UpdateApril 14, 20263 updates tracked since enumeration
NPPES CertifiedApril 14, 2026
✔ NPI 1104012921 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A94075
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
200 E ANAHEIM ST, Wilmington, CA 90744
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Fantaye Merid M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Fantaye Merid reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Northeast Community Clinic
Same address
Federally Qualified Health Center (FQHC)
200 E ANAHEIM ST
Wilmington, CA 90744
  • Reassigned Medicare billing, California enrollment
  • 45 clinicians in this Medicare group
NPI 1700097540 (310) 522-8700

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90744 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

EMMA B. TREJO MD
Internal Medicine
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700
MS. JOSEPHINE MARLENE SERVIN L.C.S.W
Social Worker (Clinical)
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700
LAURA MOTA DDS
Dentist (Dental Public Health)
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (888) 311-6322
VERONICA ROCIO GAMARRA
Health Educator
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700
KAYLA NOELLE MACAPAGAL
Physician Assistant
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700
MR. DAVID LOREN MARCUS M.D.
Psychiatry & Neurology (Psychiatry)
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700
LUISA RAMIREZ
Health Educator
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700
MR. RALPH ERBIE MICHAEL PAEZ RDH
Dental Hygienist
200 E ANAHEIM ST
WILMINGTON, CA 90744
Los Angeles County (310) 522-8700

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 Fantaye Merid's NPI number?

The NPI number for Fantaye Merid is 1104012921. It was assigned to this individual provider in the NPPES registry on September 16, 2007.

Where is Fantaye Merid located?

Fantaye Merid practices at 200 E Anaheim St, Wilmington, CA 90744. The listed phone number is (310) 522-8700.

What is Fantaye Merid's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Fantaye Merid enrolled in Medicare?

Yes. Fantaye Merid is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Fantaye Merid's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Fantaye Merid reassigns Medicare benefits to Northeast Community Clinic (Wilmington, CA). The 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 Fantaye Merid's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Fantaye Merid was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.