Active NPI
David O Zepeda, MD
- Gastroenterology Physician
- Aurora, IL
National Provider Identifier
1114036365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 036-076623
- Practice address
- 1221 N Highland Ave
Aurora, IL 60506-1404 - Phone
- (630) 859-8700
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 036-076623 | IL | Primary |
Addresses
Primary practice location
1221 N Highland Ave
Aurora, IL 60506-1404
Mailing address
2357 Sequoia Dr
Aurora, IL 60506-6222
Phone (630) 859-6800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04515143 | Other | IL | BCBS# |
| 036076623 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-076623 | IL | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487808000000",
"number": "1114036365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2357 SEQUOIA DR",
"city": "AURORA",
"state": "IL",
"postal_code": "605066222",
"telephone_number": "630-859-6800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 N HIGHLAND AVE",
"city": "AURORA",
"state": "IL",
"postal_code": "605061404",
"telephone_number": "630-859-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZEPEDA",
"first_name": "DAVID",
"middle_name": "O",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2017-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036-076623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS#",
"identifier": "04515143",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036076623",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.