Peter Zack, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

02005639A Issued in IN

Practice address

1000 Oakland Dr
Kalamazoo, MI 49008-1282

Phone

(269) 337-6019

NPI assigned

Jun 15, 2016

Last updated

Jan 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Emergency Medicine

Education

West Virginia School of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pzack432667@direct.franciscanalliance.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarksville Emergency Group, PC

  • Emergency Medicine Physician
  • Corydon, IN
  • NPI 1023487154
  Medicare reassignment Care Compare group NPD
• Clarksville Physician Services PC

  • Internal Medicine Physician
  • Corydon, IN
  • NPI 1811629546
  Medicare reassignment NPD
• North Indiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • La Porte, IN
  • NPI 1144691478
  Medicare reassignment NPD

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

• Franciscan Health Michigan City

  dba Franciscan Health Michigan City at La Porte

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1679336747
  Care Compare affiliation
• Franciscan Health Michigan City

  • General Acute Care Hospital
  • Michigan City, IN
  • NPI 1710051941
  Care Compare affiliation

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1255781852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282",
            "telephone_number": "269-337-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282",
            "telephone_number": "269-337-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACK",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022696",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02005639A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gene Yu, D.O.
• Natalia Elizabeth Yuen
• Alyssa M Yuill, DPT
• Ywca of Kalamazoo
• Jennifer Zachary, A-GNP
• Farzana Zafreen
• Ibrahim Zahid, MD
• Mehak Zahra, MD
• Paige Zajda, NURSE
• Joseph Zaki, DO

• Emergency Medicine Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.