Individual provider Active NPI

Zachary Lindy Whitaker, DO

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1205457603
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
011429 Issued in AZ
Practice address
19389 N 59TH Ave
Glendale, AZ 85308-6500
Phone
(623) 537-6000
Fax
(623) 537-6014
NPI assigned
Apr 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 011429 AZ
Family Medicine Physician 207Q00000X 011429 AZ Primary

Addresses

Primary practice location

19389 N 59TH Ave
Glendale, AZ 85308-6500

Mailing address

19389 N 59TH Ave
Glendale, AZ 85308-6500
Phone (623) 537-6000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111002489 AZ Practitioner - Family Practice 5890118350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2 Market Plaza Way
Mechanicsburg, PA 17055-5679

26520 Network PL
Chicago, IL 60673-1265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011429AZMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University Current Accepting new patients
Midwestern University CurrentSince Sep 29, 2025 Accepting new patients
Midwestern University CurrentSince Sep 29, 2025 Accepting new patients

Locations

19389 N 59th Ave
Glendale, AZ 85308

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

Organizations & group practices 3

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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1205457603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19389 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086500",
            "telephone_number": "623-537-6000",
            "fax_number": "623-806-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19389 N 59TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086500",
            "telephone_number": "623-537-6000",
            "fax_number": "623-537-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "ZACHARY",
        "middle_name": "LINDY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "AZ",
            "license": "011429",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "011429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.