Individual provider Active NPI

Jason Zatkoff, DO

  • Anesthesiology Physician
  • Warren, MI
National Provider Identifier
1164840930
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5101025124 Issued in MI
Practice address
11012 E 13 Mile Rd Ste 112a
Warren, MI 48093-2546
Phone
(586) 751-9800
NPI assigned
Mar 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 5101025124 MI
Anesthesiology Physician 207L00000X 5101025124 MI Primary

Addresses

Primary practice location

11012 E 13 Mile Rd Ste 112a
Warren, MI 48093-2546

Mailing address

1507 Cole St
Birmingham, MI 48009-7063
Phone (248) 252-8768

Other practice location 1

22401 Foster Winter Dr
Southfield, MI 48075-3724
Phone (248) 423-5198

Other practice location 2

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 585-3023

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190814003589 MI Practitioner - AnesthesiologyPractitioner - Pain Management 2365744794 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians
Anesthesia Associates of Ann Arbor PLLCGroup PAC ID 1355317223, 213 clinicians

Practice addresses (Care Compare)

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

46325 W Twelve Mile Rd
Novi, MI 48377-2456
Phone (248) 618-2121

Hospital & facility affiliations

  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
  • Surgeons Choice Medical Center Hospital, Southfield, MI, CCN 230301
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Long Lake Anesthesiology Consultants, PLC Anesthesiology CurrentSince Oct 1, 2024 Accepting new patients
Motor City Anesthesia Services PLLC Anesthesiology CurrentSince May 20, 2024 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Pain Medicine CurrentSince Sep 20, 2022 Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

18100 Oakwood Blvd
Ste 100
Dearborn, MI 48124
Phone (313) 240-7668

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Interoperability endpoints

  • Direct secure messaging: jzatkoff21335@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1164840930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 COLE ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097063",
            "telephone_number": "248-252-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD STE 112A",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932546",
            "telephone_number": "586-751-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22401 Foster Winter Dr",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480753724",
            "country_code": "US",
            "telephone_number": "248-423-5198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44405 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-585-3023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZATKOFF",
        "first_name": "JASON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-30",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "5101025124",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101025124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.