Individual provider Active NPI

Ellen Damon Zurawski, PA-C

  • Physician Assistant
  • Fort Sam Houston, TX
National Provider Identifier
1174514954
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02069 Issued in TX
Practice address
3551 Roger Brooke Drive
Department of Emergency Medicine
Fort Sam Houston, TX 78234
Phone
(210) 916-5551
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02069 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Drive
Department of Emergency Medicine
Fort Sam Houston, TX 78234

Mailing address

13614 Paradise CRK
San Antonio, TX 78253-5463
Phone (210) 679-5028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702002297 TX Order and Referring Only - Physician Assistant 2860815149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1174514954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13614 PARADISE CRK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535463",
            "telephone_number": "210-679-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DRIVE",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZURAWSKI",
        "first_name": "ELLEN",
        "middle_name": "DAMON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.