Individual provider Active NPI

Anthony P Zollo, D.O.

  • Internal Medicine Physician
  • Statesville, NC
National Provider Identifier
1225019946
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9701905 Issued in NC
Practice address
124 Sunset Hill Road
Statesville, NC 28625-2729
Phone
(704) 872-8711
Fax
(704) 872-5866
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102037126 VA
Internal Medicine Physician 207R00000X 9701905 NC Primary

Addresses

Primary practice location

124 Sunset Hill Road
Statesville, NC 28625-2729

Mailing address

124 Sunset Hill Rd
Statesville, NC 28625-2729
Phone (704) 872-8711

Other identifiers 16

IdentifierTypeStateIssuer
010112591MedicaidVA
2129939OtherMAMSI
5586237OtherAETNA
TN0122OtherJOHN DEERE HEALTH (W/S)
010112516MedicaidVA
891130NMedicaidNC
1130NOtherNCBCBS
76912OtherMEDCOST
TN0105OtherJOHN DEERE HEALTH (MA)
010112460MedicaidVA
166428OtherVAANTHEM (GALAX)
167242OtherVAANTHEM (W/S)
2657722OtherAETNA
P00208710OtherVAMEDICARE RAILROAD
709406002OtherNCCIGNA HEALTHCARE
TN0121OtherJOHN DEERE HEALTH (GAL)

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address azollo238911@nyumc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040206000792 NC Practitioner - Internal Medicine 8224921788
I20151022002450 NY Practitioner - Internal Medicine 8224921788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

11700 Main Rd
Suite 7
Mattituck, NY 11952-1525
Phone (631) 963-4770

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-2701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9701905NCMDInternal Medicine Physician
0102037126VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
New York University Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates PC Internal Medicine Past Accepting new patients
BT Heart and Vascular Center, PLLC Past Accepting new patients

Locations

74825 Main Rd
Greenport, NY 11944
Phone (631) 477-1720

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

11700 Main Rd
Ste 2
Mattituck, NY 11952

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: anthony-zollo@swishermedicine.e-mdsdirect.com
  • Direct secure messaging: azollo238911@nyumc.direct-ci.com

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1225019946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SUNSET HILL RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286252729",
            "telephone_number": "704-872-8711",
            "fax_number": "704-872-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SUNSET HILL ROAD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286252729",
            "telephone_number": "704-872-8711",
            "fax_number": "704-872-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLLO",
        "first_name": "ANTHONY",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102037126",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9701905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010112591",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2129939",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5586237",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH (W/S)",
            "identifier": "TN0122",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010112516",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891130N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1130N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "76912",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH (MA)",
            "identifier": "TN0105",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010112460",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM (GALAX)",
            "identifier": "166428",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM (W/S)",
            "identifier": "167242",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2657722",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00208710",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "709406002",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH (GAL)",
            "identifier": "TN0121",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "azollo238911@nyumc.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "74825 Main Rd",
            "city": "Greenport",
            "state": "NY",
            "country_code": "US",
            "postal_code": "119442823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.