Individual provider Active NPI

Kevin John Ziegler, PA-C

  • Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1023129806
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109340 Issued in FL
Practice address
3730 7TH Ter Ste 101
Vero Beach, FL 32960-6556
Phone
(772) 567-2332
Fax
(844) 812-2806
NPI assigned
Aug 31, 2006
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA-001195-L PA
Physician Assistant 363A00000X PA9109340 FL Primary

Addresses

Primary practice location

3730 7TH Ter Ste 101
Vero Beach, FL 32960-6556

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 432-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702000905 FL Practitioner - Physician Assistant 6002990975 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA-001195-LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince May 15, 2023 Accepting new patients
Pennsylvania Heart Group LTD Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

3730 7th Ter
Ste 101
Vero Beach, FL 32960
Phone (772) 567-2332

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1023129806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-432-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 7TH TER STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606556",
            "telephone_number": "772-567-2332",
            "fax_number": "844-812-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEGLER",
        "first_name": "KEVIN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA-001195-L",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.