Individual provider Active NPI

Joseph Roy Zelk, DNP

  • Family Nurse Practitioner
  • Tigard, OR
National Provider Identifier
1053468728
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20055006NP Issued in OR
Practice address
10220 SW Greenburg Rd.
Suite 150
Tigard, OR 97223-5529
Phone
(503) 255-1200
Fax
(503) 408-6856
NPI assigned
Jan 4, 2007
Last updated
Dec 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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 20055006NP OR Primary

Addresses

Primary practice location

10220 SW Greenburg Rd.
Suite 150
Tigard, OR 97223-5529

Mailing address

10220 SW Greenburg Rd.
Suite 150
Tigard, OR 97223-5529
Phone (503) 255-1200

Other identifiers 1

IdentifierTypeStateIssuer
9057555MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20160421001490 OR Order and Referring Only - Nurse Practitioner 0244290724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20055006NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Medicine Group LLC Past Accepting new patients
Northwest Primary Care Group, PC Family Past Accepting new patients
Arete NW LLC Past Accepting new patients
Richard W. Moore DDS PC Past Accepting new patients
Advanced Sleep Health, LLC Past Accepting new patients

Organizations & group practices 5

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1053468728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 SW GREENBURG RD.",
            "address_2": "SUITE 150",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235529",
            "telephone_number": "503-255-1200",
            "fax_number": "503-408-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 SW GREENBURG RD.",
            "address_2": "SUITE 150",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972235529",
            "telephone_number": "503-255-1200",
            "fax_number": "503-408-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELK",
        "first_name": "JOSEPH",
        "middle_name": "ROY",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "20055006NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9057555",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.