Individual provider Active NPI

Habib Zalzal

  • Pediatric Otolaryngology Physician
  • Washington, DC
National Provider Identifier
1174918908
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
MD047973 Issued in DC
Practice address
111 Michigan Ave NW Ste 3W-800
Washington, DC 20010
Phone
(202) 476-3659
NPI assigned
Mar 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 27431 WV
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Otolaryngology Physician 207YP0228X MD047973 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW Ste 3W-800
Washington, DC 20010

Mailing address

111 Michigan Ave NW Ste 3W-800
Washington, DC 20010-2916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20210420002754 DC Practitioner - OtolaryngologyPractitioner - Pediatric Medicine 6608284203 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27431WVMDOtolaryngology Physician
MD047973DCMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Current Accepting new patients
Children's Hospital CurrentSince Apr 15, 2021 Accepting new patients
Children's Hospital CurrentSince Apr 15, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

111 Michigan Ave NW
Ste 3W800
Washington, DC 20010
Phone (202) 476-3659

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.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1174918908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW STE 3W-800",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW STE 3W-800",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20010",
            "telephone_number": "202-476-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALZAL",
        "first_name": "HABIB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WV",
            "license": "27431",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "DC",
            "license": "MD047973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.