Individual provider Active NPI

Konstantinos Zarkadas, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1083643704
Registry record updated Mar 17, 2018
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(1) exclusion effective Nov 20, 2023.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
240460 Issued in NY
Practice address
575 W 161St St
New York, NY 10032-6101
Phone
(212) 928-8888
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Internal Medicine Physician 207R00000X 240460 NY Primary

Addresses

Primary practice location

575 W 161St St
New York, NY 10032-6101

Mailing address

PO Box 5549
Astoria, NY 11105-5549

Other practice location 1

229 W 97th St Apt 1D
New York, NY 10025-5610
Phone (212) 662-0293

Other identifiers 2

IdentifierTypeStateIssuer
02782350MedicaidNY
240460OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kzark Medical P.C. Past Accepting new patients
K Zark Medical P.C. Past Accepting new patients
Boro Medical, P.C. Internal Medicine Past Accepting new patients
K Zark Medical P.C. Internal Medicine Past Accepting new patients

Organizations & group practices 4

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1083643704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5549",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111055549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 W 161ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100326101",
            "telephone_number": "212-928-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 W 97th St Apt 1D",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100255610",
            "country_code": "US",
            "telephone_number": "212-662-0293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZARKADAS",
        "first_name": "KONSTANTINOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "240460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02782350",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "240460",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.