Individual provider Active NPI

Mary L Zozulin, MD

  • Obstetrics & Gynecology Physician
  • Waterbury, CT
National Provider Identifier
1174626337
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
042157 Issued in CT
Practice address
60 Westwood Ave
Suite 100
Waterbury, CT 06708-2460
Phone
(203) 573-1425
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 042157 CT Primary

Addresses

Primary practice location

60 Westwood Ave
Suite 100
Waterbury, CT 06708-2460

Mailing address

60 Westwood Ave
Suite 100
Waterbury, CT 06708-2460
Phone (203) 573-1425

Other identifiers 2

IdentifierTypeStateIssuer
001421578MedicaidCT
010042157CT01OtherCTBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.08 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21373SCMDRegistered Nurse
042157CTMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: mary.zozulin.2@10170.direct.athenahealth.com
  • Direct secure messaging: mary.zozulin.1@16244.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1174626337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 100",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082460",
            "telephone_number": "203-573-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WESTWOOD AVE",
            "address_2": "SUITE 100",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082460",
            "telephone_number": "203-573-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOZULIN",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "042157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001421578",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010042157CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.