NPIMap

Individual provider Active NPI

Theodossis Zacharis, MD

  • Pulmonary Disease Physician
  • New Smyrna Beach, FL
National Provider Identifier
1205889243
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME95732 Issued in FL
Practice address
1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone
(386) 423-0505
Fax
(386) 423-0515
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME95732 FL
Pulmonary Disease Physician 207RP1001X ME95732 FL Primary

Addresses

Primary practice location

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201

Mailing address

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

Other identifiers 1

IdentifierTypeStateIssuer
ME95732OtherFLME#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060802000488 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0648283960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PCCC of Volusia LLCGroup PAC ID 7911910237, 15 clinicians

Practice addresses (Care Compare)

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

Hospital & facility affiliations

  • Trilogy Home Healthcare Home health agency, Jacksonville, FL, CCN 107689
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
  • Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Diagnostic and Sleeping Disorder, Inc. CurrentSince Dec 1, 2015 Accepting new patients
PCCC of Volusia LLC Critical Care Medicine CurrentSince Jul 1, 2006 Accepting new patients

Locations

575 N Clyde Morris Blvd
Ste B
Daytona Beach, FL 32114
Phone (386) 258-7322

638 W Plymouth Ave
Deland, FL 32720
Phone (386) 279-0006

638 W Plymouth Ave
Ste 1
Deland, FL 32720

1055 N Dixie Fwy
Ste 1
New Smyrna Beach, FL 32168
Phone (386) 423-0505

780 Dunlawton Ave
Ste 1
Port Orange, FL 32127
Phone (386) 222-6111

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71631
  • Direct secure messaging: theodossis.zacharis@pccc.directbygreenway.com

Organizations & group practices 2

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1205889243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "address_2": "SUITE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505",
            "fax_number": "386-423-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "address_2": "SUITE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505",
            "fax_number": "386-423-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHARIS",
        "first_name": "THEODOSSIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME95732",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME95732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME#",
            "identifier": "ME95732",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.