Individual provider Active NPI

Marco Edgardo Zaldivar, RNFA

  • Registered Nurse First Assistant
  • Mesa, AZ
National Provider Identifier
1205004447
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN122134 Issued in AZ
Practice address
8915 E Pampa Ave
Mesa, AZ 85212-2834
Phone
(480) 636-9223
Fax
(480) 686-9223
NPI assigned
Feb 11, 2008
Last updated
Feb 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN122134 AZ
Registered Nurse First Assistant 163WR0006X RN122134 AZ Primary

Addresses

Primary practice location

8915 E Pampa Ave
Mesa, AZ 85212-2834

Mailing address

8915 E Pampa Ave
Mesa, AZ 85212-2834
Phone (480) 636-9223

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN122134AZMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage First Assisting LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1205004447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 E PAMPA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122834",
            "telephone_number": "480-636-9223",
            "fax_number": "480-686-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 E PAMPA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122834",
            "telephone_number": "480-636-9223",
            "fax_number": "480-686-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALDIVAR",
        "first_name": "MARCO",
        "middle_name": "EDGARDO",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN122134",
            "primary": false
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "AZ",
            "license": "RN122134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.