Individual provider Active NPI

Salvatore Zummo, PA-C

  • Medical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1174584510
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3071 Issued in AZ
Practice address
12305 E Lupine Ave
Scottsdale, AZ 85259-3302
Phone
(602) 717-6031
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3071 AZ Primary

Addresses

Primary practice location

12305 E Lupine Ave
Scottsdale, AZ 85259-3302

Mailing address

12305 E Lupine Ave
Scottsdale, AZ 85259-3302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20041122001038 AZ Practitioner - Physician Assistant 2264497973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sean M Ormond MD LLCGroup PAC ID 4082026455, 3 clinicians

Practice addresses (Care Compare)

18205 N 51St Ave
Glendale, AZ 85308-1491
Phone (602) 492-9821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3071AZMDPsychiatry Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBCBED/Endpoint/BBCBED

Organizations & group practices 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1174584510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12305 E LUPINE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12305 E LUPINE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593302",
            "telephone_number": "602-717-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUMMO",
        "first_name": "SALVATORE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.