Individual provider Active NPI

Stergios Zissis, NP

  • Acute Care Nurse Practitioner
  • Coppell, TX
National Provider Identifier
1083211726
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1064159 Issued in TX
Practice address
809 S Macarthur Blvd Ste 400-2
Coppell, TX 75019-4260
Phone
(214) 400-5548
NPI assigned
Oct 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1064159 TX Primary

Addresses

Primary practice location

809 S Macarthur Blvd Ste 400-2
Coppell, TX 75019-4260

Mailing address

820 S Macarthur Blvd # 105-164
Coppell, TX 75019-4216
Phone (214) 400-5548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201216000810 NY Practitioner - Nurse Practitioner 3274945266 Reassigns benefits to 2 organizations
I20221004000125 TX Practitioner - Nurse Practitioner 3274945266 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access 360 Care Inc CurrentSince Sep 1, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince Nov 30, 2020 Accepting new patients
Ad Precision Medical PLLC CurrentSince May 1, 2023 Accepting new patients
Strong Renal Group CurrentSince Nov 1, 2021 Accepting new patients
The Unity Hospital of Rochester CurrentSince Nov 30, 2020 Accepting new patients

Locations

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

601 Elmwood Ave
#675
Rochester, NY 14642
Phone (585) 275-4517

4381 W Green Oaks Blvd
#10
Arlington, TX 76016
Phone (682) 302-0306

4381 W Green Oaks Blvd
Ste 103
Arlington, TX 76016
Phone (682) 302-0306

9901 Valley Ranch Pkwy E
Ste 1015
Irving, TX 75063
Phone (972) 373-0303

Interoperability endpoints

  • Direct secure messaging: szissis94970@direct.urmc.rochester.edu
  • Direct secure messaging: ms_szissis@landmarkhealth-direct.org

Organizations & group practices 6

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": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1083211726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S MACARTHUR BLVD # 105-164",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194216",
            "telephone_number": "214-400-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S MACARTHUR BLVD STE 400-2",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194260",
            "telephone_number": "214-400-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISSIS",
        "first_name": "STERGIOS",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-06",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1064159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

Verify at the official NPI Registry.