Individual provider Active NPI

Zachary Q. Botone, MD

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1063614337
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N3510 Issued in TX
Practice address
2740 N. Hwy 360
Suite 100
Grand Prairie, TX 75050
Phone
(972) 606-8300
Fax
(972) 606-4940
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N3510 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2740 N. Hwy 360
Suite 100
Grand Prairie, TX 75050

Mailing address

2740 N. Hwy 360
Suite 100
Grand Prairie, TX 75050
Phone (972) 606-8300

Other identifiers 3

IdentifierTypeStateIssuer
215868501MedicaidTX
BP1-0026105OtherINSTITUTIONAL PERMIT
8F5134OtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091014000569 TX Practitioner - Family Practice 8527104025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Emory University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

600 S Main St
Fort Worth, TX 76104-2410
Phone (817) 882-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 7, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 15, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Family Medicine CurrentSince Nov 7, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Sep 15, 2018 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

2999 Olympus Blvd
Ste 300
Coppell, TX 75019
Phone (214) 645-6800

2999 Olympus Blvd
Coppell, TX 75019
Phone (469) 647-4250

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8194 Walnut Hill Ln
Ste 100
Dallas, TX 75231
Phone (214) 645-3900

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

2210 N State Highway 360
Grand Prairie, TX 75050
Phone (972) 606-8300

2740 N State Highway 360
Ste 100
Grand Prairie, TX 75050
Phone 9726068300 ext. 266

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 7

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 3

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1063614337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 N. HWY 360",
            "address_2": "SUITE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75050",
            "telephone_number": "972-606-8300",
            "fax_number": "972-606-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 N. HWY 360",
            "address_2": "SUITE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75050",
            "telephone_number": "972-606-8300",
            "fax_number": "972-606-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTONE",
        "first_name": "ZACHARY",
        "middle_name": "Q.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N3510",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "215868501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8F5134",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.