Individual provider Active NPI

Magdalena Czerkawska-Zydzik, M.D.

  • Pediatric Adolescent Medicine Physician
  • Springfield, MA
National Provider Identifier
1053308353
Registry record updated Jul 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
211993 Issued in MA
Practice address
299 Carew St
Suite 210
Springfield, MA 01104-2301
Phone
(413) 732-5580
Fax
(413) 732-5634
NPI assigned
Oct 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 211993 MA Primary

Addresses

Primary practice location

299 Carew St
Suite 210
Springfield, MA 01104-2301

Mailing address

299 Carew St
Suite 210
Springfield, MA 01104-2301
Phone (413) 732-5580

Other identifiers 1

IdentifierTypeStateIssuer
0157040MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211993MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Care Associates, P.C. Past Accepting new patients
Mercy Inpatient Medical Associates Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mczerkawska13409@direct.chppoc.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1128211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278806400000",
    "number": "1053308353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 CAREW ST",
            "address_2": "SUITE 210",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042301",
            "telephone_number": "413-732-5580",
            "fax_number": "413-732-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 CAREW ST",
            "address_2": "SUITE 210",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042301",
            "telephone_number": "413-732-5580",
            "fax_number": "413-732-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERKAWSKA-ZYDZIK",
        "first_name": "MAGDALENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-02",
        "last_updated": "2010-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "211993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0157040",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.