NPIMap

Individual provider Active NPI

Anton Vladimir Zaryanov, DO

  • Orthopaedic Surgery of the Spine Physician
  • Rockwall, TX
National Provider Identifier
1013285758
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
R4350 Issued in TX
Practice address
3142 Horizon Rd Ste 100
Rockwall, TX 75032-7815
Phone
(972) 772-9600
Fax
(972) 772-9601
NPI assigned
Dec 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 54285 CO
Orthopaedic Surgery of the Spine Physician 207XS0117X 5315058385 MI
Orthopaedic Surgery of the Spine Physician 207XS0117X 54285 CO
Orthopaedic Surgery of the Spine Physician 207XS0117X R4350 TX Primary

Addresses

Primary practice location

3142 Horizon Rd Ste 100
Rockwall, TX 75032-7815

Mailing address

3142 Horizon Rd Ste 100
Rockwall, TX 75032-7815
Phone (972) 772-9600

Other identifiers 2

IdentifierTypeStateIssuer
370936YL31OtherCOMEDICARE PTAN
85035769MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stt@116.direct.myezyaccess.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171207000026 TX Practitioner - Orthopedic Surgery 1658502950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Back CareGroup PAC ID 1951604313, 50 clinicians

Practice addresses (Care Compare)

3142 Horizon Rd
Suite 100
Rockwall, TX 75032-7815
Phone (817) 442-9300

Hospital & facility affiliations

  • Texas Health Presbyterian Hospital Rockwall Hospital, Rockwall, TX, CCN 670044
  • Texas Health Presbyterian Hospital Allen Hospital, Allen, TX, CCN 450840
  • Hunt Regional Medical Center Hospital, Greenville, TX, CCN 450352

Merit-based Incentive Payment System (MIPS)

Final score
70.04 of 100Reported as individual
Quality
50.99
Promoting interoperability
90
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion212
Laminectomy or laminotomy (partial removal of spine bones)88
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5315058385MIMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Back Care Orthopaedic Surgery of the Spine CurrentSince Dec 4, 2017 Accepting new patients
Texas Health Back Care Orthopaedic Surgery of the Spine CurrentSince Dec 4, 2017 Accepting new patients

Locations

1120 Raintree Cir
Ste 110
Allen, TX 75013

1340 S Main St
Ste 100
Grapevine, TX 76051
Phone (682) 651-1908

3509 Spectrum Blvd
#B
Richardson, TX 75082
Phone (972) 772-9600

3142 Horizon Rd
Ste 100
Rockwall, TX 75032
Phone (682) 651-1908

1545 E Southlake Blvd
Southlake, TX 76092
Phone (817) 557-8205

Interoperability endpoints

  • Direct secure messaging: azaryanov1238516@direct.texashealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1013285758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD STE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327815",
            "telephone_number": "972-772-9600",
            "fax_number": "972-772-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD STE 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327815",
            "telephone_number": "972-772-9600",
            "fax_number": "972-772-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARYANOV",
        "first_name": "ANTON",
        "middle_name": "VLADIMIR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-08",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "54285",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MI",
            "license": "5315058385",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CO",
            "license": "54285",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "R4350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "370936YL31",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85035769",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stt@116.direct.myezyaccess.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3142 Horizon Rd Ste 100",
            "city": "Rockwall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750327815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.