Individual provider Active NPI

Marc Jay Zuckerman, M.D.

  • Gastroenterology Physician
  • El Paso, TX
National Provider Identifier
1245268168
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G6251 Issued in TX
Practice address
4801 Alberta Ave.
El Paso, TX 79905
Phone
(915) 545-6647
Fax
(915) 545-9799
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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 G6251 TX
Gastroenterology Physician 207RG0100X G6251 TX Primary

Addresses

Primary practice location

4801 Alberta Ave.
El Paso, TX 79905

Mailing address

PO Box 9520
El Paso, TX 79995-9520
Phone (915) 545-9795

Other identifiers 1

IdentifierTypeStateIssuer
118213101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20081106000727 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 8729147616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Tufts University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

4800 Alberta Ave
El Paso, TX 79905-2709
Phone (915) 215-5666

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5900

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-5900

4845 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-4956

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy35
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Internal Medicine CurrentSince Dec 15, 1986 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Dec 15, 1986 Accepting new patients

Locations

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

4800 Alberta Ave
#101
El Paso, TX 79905
Phone (915) 215-4478

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Interoperability endpoints

  • Direct secure messaging: marc.zuckerman@direct.myhealthep.org

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 3

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1245268168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9520",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799959520",
            "telephone_number": "915-545-9795",
            "fax_number": "915-545-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE.",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79905",
            "telephone_number": "915-545-6647",
            "fax_number": "915-545-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKERMAN",
        "first_name": "MARC",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G6251",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "G6251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118213101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.