Individual provider Active NPI

John R. Zandt, M.D.

  • Hospitalist Physician
  • Waukesha, WI
National Provider Identifier
1104899798
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
31971-020 Issued in WI
Practice address
Waukesha Memorial Hospital-Hospitalist Program
725 American Avenue Room 2036
Waukesha, WI 53188
Phone
(262) 928-1000
Fax
(262) 928-6140
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31971 WI
Hospitalist Physician 208M00000X 31971-020 WI Primary

Addresses

Primary practice location

Waukesha Memorial Hospital-Hospitalist Program
725 American Avenue Room 2036
Waukesha, WI 53188

Mailing address

N17 W24100 Riverwood Drive Suite 250
Prohealth Care Medical Associates Inc.
Waukesha, WI 53188-1177
Phone (262) 928-4100

Other identifiers 1

IdentifierTypeStateIssuer
31703600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20110218000889 WI Practitioner - Internal Medicine 7012198302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia St Marys Hospital Milwaukee IncGroup PAC ID 5890604722, 311 clinicians

Practice addresses (Care Compare)

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

Hospital & facility affiliations

  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31971-020WIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Sep 5, 2019 Accepting new patients
Apogee Medical Group Waukesha, SC Hospitalist CurrentSince Sep 1, 2018 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Current Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Sep 5, 2019 Accepting new patients
Prohealth Medical Group Inc Internal Medicine Past Accepting new patients
Sacred Heart Rehabilitation Institute, Inc. PastSince Jun 21, 2022 Accepting new patients

Locations

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

725 American Ave
Rm 2036
Waukesha, WI 53188
Phone (262) 928-1000

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

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.

Hospital & facility affiliations 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1104899798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N17 W24100 RIVERWOOD DRIVE SUITE 250",
            "address_2": "PROHEALTH CARE MEDICAL ASSOCIATES INC.",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881177",
            "telephone_number": "262-928-4100",
            "fax_number": "262-928-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAUKESHA MEMORIAL HOSPITAL-HOSPITALIST PROGRAM",
            "address_2": "725 AMERICAN AVENUE ROOM 2036",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53188",
            "telephone_number": "262-928-1000",
            "fax_number": "262-928-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDT",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "31971",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "31971-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31703600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.