Individual provider Active NPI

Robert Zylstra, MD

  • Internal Medicine Physician
  • Santa Barbara, CA
National Provider Identifier
1174652465
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G36944 Issued in CA
Practice address
2495 Glen Albyn Drive
Santa Barbara, CA 93105
Phone
(805) 682-0414
Fax
(805) 524-0658
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G36944 CA Primary

Addresses

Primary practice location

2495 Glen Albyn Drive
Santa Barbara, CA 93105

Mailing address

2495 Glen Albyn Drive
Santa Barbara, CA 93105
Phone (805) 682-0414

Other identifiers 2

IdentifierTypeStateIssuer
NPI 1174652465OtherPERSONAL NPI
G36944OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120126000682 CA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8527235845

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1174652465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 GLEN ALBYN DRIVE",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-682-0414",
            "fax_number": "805-524-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 GLEN ALBYN DRIVE",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "93105",
            "telephone_number": "805-682-0414",
            "fax_number": "805-524-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYLSTRA",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G36944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "NPI 1174652465",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G36944",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.