Individual provider Active NPI

John Alden Zarske

  • Clinical Neuropsychologist
  • Flagstaff, AZ
National Provider Identifier
1154595338
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
973 Issued in AZ
Practice address
119 E Terrace Ave Ste C
Flagstaff, AZ 86001-5267
Phone
(928) 362-1220
Fax
(928) 774-8405
NPI assigned
Apr 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 973 AZ Primary

Addresses

Primary practice location

119 E Terrace Ave Ste C
Flagstaff, AZ 86001-5267

Mailing address

1830 N Beaver St
Flagstaff, AZ 86001-1303
Phone (928) 607-8129

Other practice location 1

107 E Oak Ave
Suite 201
Flagstaff, AZ 86001-1818
Phone (928) 913-8800

Other identifiers 1

IdentifierTypeStateIssuer
730029MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2022 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
973AZMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Neuropsychology PC Clinical Neuropsychologist 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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1154595338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011303",
            "telephone_number": "928-607-8129",
            "fax_number": "928-774-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E TERRACE AVE STE C",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015267",
            "telephone_number": "928-362-1220",
            "fax_number": "928-774-8405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 E Oak Ave",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860011818",
            "country_code": "US",
            "telephone_number": "928-913-8800",
            "fax_number": "928-913-8801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZARSKE",
        "first_name": "JOHN",
        "middle_name": "ALDEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730029",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.