Individual provider Active NPI

William Paul Zickler, MD

  • Vascular Surgery Physician
  • Gainesville, GA
National Provider Identifier
1245764042
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
98406 Issued in GA
Practice address
200 S Enota Dr NE Ste 360
Gainesville, GA 30501-3466
Phone
(770) 219-4000
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 98406 GA Primary

Addresses

Primary practice location

200 S Enota Dr NE Ste 360
Gainesville, GA 30501-3466

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

22 Prestige Ln Ste 300
Dawsonville, GA 30534-6337
Phone (770) 219-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wzickler197702@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240805002815 GA Practitioner - Vascular Surgery 4183991235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 S Enota Dr NE
Suite 380
Gainesville, GA 30501-3475
Phone (770) 219-7099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)31
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

200 S Enota Dr NE
Ste 380
Gainesville, GA 30501
Phone (770) 219-7099

200 S Enota Dr NE
Ste 360
Gainesville, GA 30501
Phone (770) 219-4000

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1245764042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 360",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013466",
            "telephone_number": "770-219-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Prestige Ln Ste 300",
            "address_purpose": "LOCATION",
            "city": "Dawsonville",
            "state": "GA",
            "postal_code": "305346337",
            "country_code": "US",
            "telephone_number": "770-219-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZICKLER",
        "first_name": "WILLIAM",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "98406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wzickler197702@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 S Enota Dr NE Ste 360",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.