Active NPI
Anastasiya Zubaryeva, PA-C
- Physician Assistant
- Traverse City, MI
National Provider Identifier
1124779475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5315249289
- Practice address
- 3055 Cass Rd
Traverse City, MI 49684-7940 - Phone
- (231) 270-2100
- NPI assigned
- Jan 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
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.
-
- Gastroenterology Physician
- Traverse City, MI
- NPI 1225104011
MI
-
- Multi-Specialty Clinic/Center
- Southfield, MI
- NPI 1891109641
MI
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230217001727 | MI | Practitioner - Physician Assistant | 5092187138 | Reassigns benefits to 6 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5315249289 | MI | MD | Physician Assistant |
Specialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 5315249289 | MI | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
3055 Cass Rd
Traverse City, MI 49684-7940
Mailing address
1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-5710
Other practice location 1
4100 Park Forest Dr Ste 208
Traverse City, MI 49684-7306
Phone (231) 935-5710
Other practice location 2
18000 W 9 Mile Rd Ste 525
Southfield, MI 48075-4080
Phone (248) 327-6196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 7, 2025.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751846400000",
"number": "1124779475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SIXTH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842345",
"telephone_number": "231-935-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 CASS RD",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847940",
"telephone_number": "231-270-2100"
}
],
"practiceLocations": [
{
"address_1": "4100 Park Forest Dr Ste 208",
"address_purpose": "LOCATION",
"city": "Traverse City",
"state": "MI",
"postal_code": "496847306",
"country_code": "US",
"telephone_number": "231-935-5710",
"fax_number": "231-935-9045",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "18000 W 9 Mile Rd Ste 525",
"address_purpose": "LOCATION",
"city": "Southfield",
"state": "MI",
"postal_code": "480754080",
"country_code": "US",
"telephone_number": "248-327-6196",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZUBARYEVA",
"first_name": "ANASTASIYA",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-18",
"last_updated": "2025-07-07",
"certification_date": "2025-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5315249289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.