Organization Active NPI

Zima Medical Group, PLLC

  • Internal Medicine Physician
  • Helotes, TX
National Provider Identifier
1003288879
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ZIMA MEDICAL GROUP, PLLC
Practice address
12030 Bandera Rd
Ste. 128
Helotes, TX 78023-4735
Phone
(210) 685-8111
Fax
(210) 569-6581
NPI assigned
Oct 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Obinna Henry Ozibgo, MD
Title
Owner
Phone
(210) 241-7562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12030 Bandera Rd
Ste. 128
Helotes, TX 78023-4735

Mailing address

12030 Bandera Rd
Ste. 128
Helotes, TX 78023-4735
Phone (210) 685-8111

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151215000080 TX Part B Supplier - Clinic/Group Practice 7012218100 Receives reassigned benefits from 2 practitioners
Practice locations: Helotes, TX; San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2309544Zima Medical Group PLLC12030 Bandera Road, Ste 128, Helotes, TX 78023Certificate of waiverAug 15, 2026

National Provider Directory

National Provider Directory

Locations

16111 San Pedro Ave
Ste 123
San Antonio, TX 78232
Phone (210) 545-5755

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1003288879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 BANDERA RD",
            "address_2": "STE. 128",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234735",
            "telephone_number": "210-685-8111",
            "fax_number": "210-569-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 BANDERA RD",
            "address_2": "STE. 128",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780234735",
            "telephone_number": "210-685-8111",
            "fax_number": "210-569-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIMA MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "OZIBGO",
        "authorized_official_first_name": "OBINNA",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-241-7562",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Helotes, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.