Individual provider Active NPI

Aviva Deborah Zyskind, M.D.

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1164582607
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD32269 Issued in DC
Practice address
3020 14TH St NW
Upper Cardozo Health Center
Washington, DC 20009-6865
Phone
(202) 745-4300
Fax
(202) 299-1708
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 MD32269 DC Primary

Addresses

Primary practice location

3020 14TH St NW
Upper Cardozo Health Center
Washington, DC 20009-6865

Mailing address

3020 14TH St NW
Upper Cardozo Health Center
Washington, DC 20009-6865
Phone (202) 745-4300

Other identifiers 1

IdentifierTypeStateIssuer
4424440MedicaidDC

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20100928001408 DC Practitioner - Family PracticePractitioner - Internal Medicine 1456477322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
Albany Medical College of Union University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

5620 Ager Rd
Hyattsville, MD 20782-3729
Phone (240) 906-6600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health Care, Inc. CurrentSince May 26, 2010 Accepting new patients
Unity Health Care Inc. CurrentSince May 26, 2010 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 23, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 23, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Family Medicine Current Accepting new patients

Locations

3020 14th St NW
Uppr Cardozo
Washington, DC 20009
Phone (202) 299-1787

1310 Southern Ave SE
Washington, DC 20032
Phone (202) 574-6000

4000 Garden City Dr
Fl 4
Hyattsville, MD 20785
Phone (227) 229-8532

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1164582607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 14TH ST NW",
            "address_2": "UPPER CARDOZO HEALTH CENTER",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096865",
            "telephone_number": "202-745-4300",
            "fax_number": "202-299-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 14TH ST NW",
            "address_2": "UPPER CARDOZO HEALTH CENTER",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096865",
            "telephone_number": "202-745-4300",
            "fax_number": "202-299-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYSKIND",
        "first_name": "AVIVA",
        "middle_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD32269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4424440",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3020 14th St NW",
            "address_2": "Upper Cardozo Health Center",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200096865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.