Organization Active NPI

Zeidan Diabetes & Endocrinology LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Dayton, OH
National Provider Identifier
1083410039
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ZEIDAN DIABETES & ENDOCRINOLOGY LLC
Practice address
5250 Far Hills Ave Ste 150
Dayton, OH 45429-2389
Phone
(614) 832-2688
NPI assigned
Feb 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Dr. Trisha Lynn Zeidan, MDNPI 1679695985
Title
Owner
Phone
(614) 832-2688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

5250 Far Hills Ave Ste 150
Dayton, OH 45429-2389

Mailing address

1614 Gatekeeper Way
Centerville, OH 45458-3954
Phone (614) 832-2688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250318001489 OH Part B Supplier - Clinic/Group Practice 7517489768 Receives reassigned benefits from 2 practitioners
Practice locations: Dayton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2319531Zeidan Diabetes & Endocrinology LLC5250 Far Hills Avenue, Suite 150, Dayton, OH 45429Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1083410039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 GATEKEEPER WAY",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583954",
            "telephone_number": "614-832-2688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 FAR HILLS AVE STE 150",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292389",
            "telephone_number": "614-832-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZEIDAN DIABETES & ENDOCRINOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "ZEIDAN",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-832-2688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.