Individual provider Active NPI

Candace Folley Zubricky, MD

  • Family Medicine Physician
  • Westlake, OH
National Provider Identifier
1134197841
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35063777Z Issued in OH
Practice address
25200 Center Ridge Rd
Suite 2000
Westlake, OH 44145-4141
Phone
(440) 331-3321
Fax
(440) 331-3373
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35063777Z OH Primary

Addresses

Primary practice location

25200 Center Ridge Rd
Suite 2000
Westlake, OH 44145-4141

Mailing address

24651 Center Ridge Rd
Ste 350
Westlake, OH 44145-5635
Phone (440) 895-5056

Other identifiers 10

IdentifierTypeStateIssuer
10801862OtherCAQH
1780634279OtherGROUP NPI
CA4511OtherRR MEDICARE GROUP
0969699MedicaidOH
3610861OtherGROUP ASC MEDICARE
D368301OtherGROUP IND DIAGNOSTICS MED
P00064895OtherRR MEDICARE INDIVIDUAL
0119204OtherGROUP MEDICAID
121423OtherKAISER
9273172OtherGROUP MEDICARE

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

LicenseStateTypeSpecialty
35063777ZOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physicians Centers, Inc Past Accepting new patients

Organizations & group practices 1

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1134197841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24651 CENTER RIDGE RD",
            "address_2": "STE 350",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455635",
            "telephone_number": "440-895-5056",
            "fax_number": "440-333-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD",
            "address_2": "SUITE 2000",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454141",
            "telephone_number": "440-331-3321",
            "fax_number": "440-331-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUBRICKY",
        "first_name": "CANDACE",
        "middle_name": "FOLLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35063777Z",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10801862",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1780634279",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CA4511",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0969699",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ASC MEDICARE",
            "identifier": "3610861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IND DIAGNOSTICS MED",
            "identifier": "D368301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL",
            "identifier": "P00064895",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "0119204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "121423",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "9273172",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.