Zachary Raymond Cresap, MD
Individual provider Active NPI Emergency Medicine Physician · Grand Blanc, MI
NPI 1124558119 · NPPES record last updated Jun 13, 2017
Key facts
- NPI
- 1124558119
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 4301113057 (MI)
- Practice address
- 1 Genesys Pkwy
Grand Blanc, MI 48439-8065 - Phone
- (810) 606-6372
- NPI assigned
- Jun 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 25
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- North Valley Emergency Physicians LC
Practice addresses (Care Compare)
170 N 1100
American Fork, UT 84003-2096
Phone (801) 714-6570
Hospital & facility affiliations
- American Fork Hospital
- Avera McKennan Hospital & University Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230206001620 | SD | Practitioner - Emergency Medicine | 5698046779 | Reassigns benefits to 1 organization |
| I20250529001946 | UT | Practitioner - Emergency Medicine | 5698046779 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301113057 | MI | MD | Emergency Medicine Physician |
| 5315086950 | MI | MD | Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| North Valley Emergency Physicians LC | Current |
Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients |
Locations
300 W 5th St
Miller, SD 57362
Phone (605) 853-0158
170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5315086950 | MI | |
| Emergency Medicine Physician | 207P00000X | 4301113057 | MI | Yes |
Addresses
Primary practice location
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Mailing address
6070 Maple TRL
Grand Blanc, MI 48439-9039
Phone (602) 499-7810
Other providers in Grand Blanc, MI
- Abigail Christine Crawford
- Candace Ray Crawley
- Noel Creager
- Creekside Counseling Group
- Creekside Counseling Group LLC
- Crescent Counseling
- Crescent Counseling
- Susan Crew
- Alexie Cronenvhet
- Ashly Crosby
All providers in Grand Blanc, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.