Individual provider Active NPI

John C Ziebarth, PA

  • Physician Assistant
  • Elko, NV
National Provider Identifier
1093758765
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA481 Issued in ID
Practice address
1993 Errecart Blvd
Elko, NV 89801-8334
Phone
(775) 753-1049
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA481 ID Primary

Addresses

Primary practice location

1993 Errecart Blvd
Elko, NV 89801-8334

Mailing address

1993 Errecart Blvd
Elko, NV 89801-8334
Phone (775) 753-1049

Other practice location 1

167 North Main Street
Tuba City, AZ 86045-0600
Phone (928) 283-2501 ext. 2781

Other identifiers 1

IdentifierTypeStateIssuer
951261MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT2 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
I20180209002445 NV Practitioner - Physician Assistant 1658261466 Reassigns benefits to 2 organizations
I20190731001489 UT Practitioner - Physician Assistant 1658261466 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA481IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Nevada Medical Hinitt PC CurrentSince Dec 3, 2018 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Jul 1, 2019 Accepting new patients
Premise Health of Nevada Medical Hinitt PC CurrentSince Dec 3, 2018 Accepting new patients
Treasure Valley Emergency Physicians Past Accepting new patients
Premier Emergency Physicians of Idaho Medical Group Past Accepting new patients
Premise Health of Nevada Medical Hinitt P C Past Accepting new patients

Locations

16906 Collection Ctr Dr
Chicago, IL 60693

1993 Errecart Blvd
Elko, NV 89801
Phone (775) 748-4826

515 W Haskell St
Winnemucca, NV 89445
Phone (775) 625-4653

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Organizations & group practices 8

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1093758765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1993 ERRECART BLVD",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018334",
            "telephone_number": "775-753-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 ERRECART BLVD",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018334",
            "telephone_number": "775-753-1049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 NORTH MAIN STREET",
            "address_purpose": "LOCATION",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "country_code": "US",
            "telephone_number": "928-283-2501 x2781",
            "fax_number": "928-283-2677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIEBARTH",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951261",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

Verify at the official NPI Registry.