Individual provider Active NPI

Heather Zeznock, D.O.

  • Surgery Physician
  • Wasilla, AK
National Provider Identifier
1154708980
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
162734 Issued in AK
Practice address
3066 E Meridian Park Loop Ste 2
Wasilla, AK 99654-7254
Phone
(907) 357-2332
Fax
(907) 357-9593
NPI assigned
Apr 30, 2015
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 162734 AK Primary

Addresses

Primary practice location

3066 E Meridian Park Loop Ste 2
Wasilla, AK 99654-7254

Mailing address

3122 E Meridian Park Loop
Wasilla, AK 99654-7255
Phone (907) 864-4625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201104002854 AK Practitioner - General Surgery 3577858729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Pacific NW Un of HS, Col of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Network of Alaska LLCGroup PAC ID 3072618859, 70 clinicians

Practice addresses (Care Compare)

3066 E Meridian Park Loop
Wasilla, AK 99654-7299
Phone (907) 357-9590

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy61
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux21
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
162734AKMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Oct 1, 2023 Accepting new patients
Medical Network of Alaska, LLC Current Accepting new patients
Medical Network of Alaska, LLC CurrentSince Oct 1, 2023 Accepting new patients
Mat-Su Valley Medical Center LLC Past Accepting new patients

Locations

3066 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

3066 E Meridian Park Loop
Ste 2
Wasilla, AK 99654
Phone (907) 333-2133

3122 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 864-4625

3331 E Meridian Park Loop
Wasilla, AK 99654
Phone (907) 357-2332

Interoperability endpoints

  • Direct secure messaging: heather.zeznock.1@27294.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1154708980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 E MERIDIAN PARK LOOP",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547255",
            "telephone_number": "907-864-4625",
            "fax_number": "907-313-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP STE 2",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547254",
            "telephone_number": "907-357-2332",
            "fax_number": "907-357-9593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEZNOCK",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AK",
            "license": "162734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

Verify at the official NPI Registry.