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DOUGLAS EDWARD MERKEL MD
NPI 1235156811
Internal Medicine - Medical Oncology in Evanston, IL

Active since July 17, 2006PECOS EnrolledAccepts Medicare Assignment
93.08/100
CMS Quality Rating
2650 RIDGE AVE, KELLOGG CANCER CENTER, EVANSTON, IL 60201(847) 570-2112(847) 570-1041 Get Directions Write a Review

NPPES record last updated: October 6, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Oct 6, 2020, Oct 21, 2019 (2 updates tracked since 2019).

About Douglas Edward Merkel Md NPPES

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

DOUGLAS EDWARD MERKEL MD (NPI 1235156811) is an individual medical oncology provider in Evanston, Illinois, licensed in Illinois (036065572) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and is a graduate of Northwestern University Feinberg Medical School (1981).

NPPES Registry Identity

NPI1235156811
Entity TypeIndividualMale
Primary Taxonomy207RX0202X
Provider Legal NameDOUGLAS EDWARD MERKELCredential: MD
Location Address2650 RIDGE AVE, KELLOGG CANCER CENTEREvanston, IL 60201
Mailing Address2650 Ridge Ave, Kellogg Cancer CenterEvanston, IL 60201-1718 · (847) 570-2112 · Fax (847) 570-1041
Phone(847) 570-2112
Fax(847) 570-1041
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 1981
Enumeration DateJuly 17, 2006
Last NPPES UpdateOctober 6, 20202 updates tracked since enumeration
NPPES CertifiedOctober 6, 2020
✔ NPI 1235156811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RX0202X
License✔ Licensed in IL · 036065572
Definition
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
2650 RIDGE AVE, Evanston, IL 60201
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Douglas Edward Merkel Md 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 ID2163453572
PECOS Enrollment IDI20050825000649
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.

Areas of Expertise CMS Part B claims 5

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 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.
1,299 services556 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
252 services223 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.
210 services64 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
26 services26 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
18 services16 patients

Hospital Affiliations CMS Care Compare 3

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

Northshore University Healthsystem - Evanston Hospital

Acute Care Hospitals · Evanston, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140010
Location2650 Ridge AveEvanston, IL 60201 · Cook County
Emergency services Birthing friendly

Swedish Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140114
Location5145 N California AveChicago, IL 60625 · Cook County
Emergency services Birthing friendly

Northwestern Lake Forest Hospital

Acute Care Hospitals · Lake Forest, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140130
Location1000 N Westmoreland RoadLake Forest, IL 60045 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60201 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
$183.39 typical visit price
range $60.08 – $183.39
Typical copayment $45.84 (range $15.02 – $45.84)
Most-billed visit code 99205
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

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.

93.08/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.79
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Capecitabine, oral, 500 mg J8521
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers156 claims11,004 services$0.69 avg. paid by Medicare
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type L8000
DME-Orthotic Devices · category DF000N
4 suppliers40 claims117 services$32.89 avg. paid by Medicare
Breast prosthesis, silicone or equal, without integral adhesive L8030
DME-Orthotic Devices · category DF000N
4 suppliers14 claims18 services$257.61 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers104 claims104 services$17.84 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
3 suppliers52 claims52 services$11.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. THOMAS LEE CIBULL M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
2650 RIDGE AVE, EVANSTON HOSPITAL
EVANSTON, IL 60201
Cook County (847) 570-2040
LAUREN ANDERSON MD
Hospitalist
2650 RIDGE AVE
EVANSTON, IL 60201
Cook County (847) 570-1027
DR. DANIEL K. WEST MD
Radiology (Diagnostic Radiology)
2650 RIDGE AVE, DEPARTMENT OF RADIOLOGY, G507
EVANSTON, IL 60201
Cook County (847) 570-2475
JOEL BERNSTEIN M.D.
Radiology (Diagnostic Radiology)
2650 RIDGE AVE, EVANSTON HOSPITAL
EVANSTON, IL 60201
Cook County (847) 570-1206
MATTHEW R. SHERWOOD MD
Internal Medicine
2650 RIDGE AVE, DIVISION OF INTERNAL MEDICINE RM 4324
EVANSTON, IL 60201
Cook County (847) 570-1010
MICHAEL T. GILLAM M.D.
Emergency Medicine
2650 RIDGE AVE, EMERGENCY MEDICINE RM G909
EVANSTON, IL 60201
Cook County (847) 570-2114
MARLENE ANGELICO CNP
Nurse Practitioner (Acute Care)
2650 RIDGE AVE, EMERGENCY MEDICINE, RM G903C
EVANSTON, IL 60201
Cook County (847) 570-1355
MINA KEROLOS MD, PHARM.D.
Hospitalist
2650 RIDGE AVE
EVANSTON, IL 60201
Cook County (847) 570-1010

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 Douglas Merkel's NPI number?

The NPI number for Douglas Merkel is 1235156811. It was assigned to this individual provider in the NPPES registry on July 17, 2006.

Where is Douglas Merkel located?

Douglas Merkel practices at 2650 Ridge Ave Kellogg Cancer Center, Evanston, IL 60201. The listed phone number is (847) 570-2112.

What is Douglas Merkel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Is Douglas Merkel enrolled in Medicare?

Yes. Douglas Merkel 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.

What insurance does Douglas Merkel accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Douglas Merkel 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 Douglas Merkel affiliated with any hospitals?

According to CMS data, Douglas Merkel is affiliated with Northshore University Healthsystem - Evanston Hospital, Swedish Hospital and Northwestern Lake Forest Hospital.

When was this NPI record last updated?

The NPPES record for Douglas Merkel was last updated on October 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.