Individual provider Active NPI

David Seth Zimmerman, PAC

  • Emergency Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1063494284
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2615 Issued in AZ
Practice address
1900 N Higley Rd
Gilbert, AZ 85234-1604
Phone
(480) 543-2485
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2615 AZ Primary

Addresses

Primary practice location

1900 N Higley Rd
Gilbert, AZ 85234-1604

Mailing address

4088 E Olive Ave
Gilbert, AZ 85234-7904
Phone (480) 539-0871

Other identifiers 6

IdentifierTypeStateIssuer
860373636OtherAZHUMANA GROUP
714619MedicaidAZ
3981220OtherAZEVERCARE GRP
453051001OtherAZGROUP HEALTH GRP
AZ0728670OtherAZBLUE CROSS BLUE SHIELD GR
AW1436OtherAZHEALTHNET GRP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040524001463 AZ Practitioner - Physician Assistant 8325029614 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association LTD Emergency Medicine Past Accepting new patients
Team Physicians of Arizona PC Emergency Medicine Past Accepting new patients
Emergency Physician Professional Association, LTD. Emergency Medicine 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1063494284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4088 E OLIVE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852347904",
            "telephone_number": "480-539-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341604",
            "telephone_number": "480-543-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "DAVID",
        "middle_name": "SETH",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "2615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GROUP",
            "identifier": "860373636",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714619",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE GRP",
            "identifier": "3981220",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH GRP",
            "identifier": "453051001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GR",
            "identifier": "AZ0728670",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GRP",
            "identifier": "AW1436",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.