Individual provider Active NPI

Jason Thomas Zalack, NP-C

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1043059249
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704369783 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2386
Phone
(231) 935-5000
NPI assigned
May 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704369783 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2386

Mailing address

Schillinger Physician Services, PC
200 Corporate Blvd
Lafayette, LA 70508
Phone (231) 735-3744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240905002365 MI Practitioner - Nurse Practitioner 0941740997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians

Practice addresses (Care Compare)

224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 352-2200

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704369783MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interlochen Emergency Group, P.C. CurrentSince Jul 26, 2024 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 1

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 1

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1043059249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SCHILLINGER PHYSICIAN SERVICES, PC",
            "address_2": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "231-735-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842386",
            "telephone_number": "231-935-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALACK",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704369783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.