NPIMap

Individual provider Active NPI

Edward J Zajac, MD

  • Interventional Cardiology Physician
  • Sioux City, IA
National Provider Identifier
1265406060
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
32426 Issued in IA
Practice address
5885 Sunnybrook Dr
Suite L-200
Sioux City, IA 51106-4203
Phone
(712) 239-4702
Fax
(712) 224-5898
NPI assigned
Feb 16, 2006
Last updated
Oct 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 32426 IA
Interventional Cardiology Physician 207RI0011X 32426 IA Primary
Interventional Cardiology Physician 207RI0011X 20824 NE
Interventional Cardiology Physician 207RI0011X 4455 SD

Addresses

Primary practice location

5885 Sunnybrook Dr
Suite L-200
Sioux City, IA 51106-4203

Mailing address

PO Box 3128
Sioux City, IA 51102-3128
Phone (712) 239-4702

Other identifiers 1

IdentifierTypeStateIssuer
0172254MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20040511000265 IA Practitioner - Cardiovascular Disease (Cardiology) 5991794380 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500

5885 Sunnybrook Dr
Suite L200
Sioux City, IA 51106-4251
Phone (712) 239-4702

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4455SDMDPharmacist
32426IAMDCardiovascular Disease Physician
20824NEMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Ida County Iowa Community Hospital Cardiovascular Disease CurrentSince May 4, 2017 Accepting new patients
Stelzer Surgery, PC Past Accepting new patients
St Lukes Health Resources Past Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

701 E 2nd St
Ida Grove, IA 51445
Phone (712) 364-3311

2004 Okoboji Ave
Milford, IA 51351
Phone (712) 338-2461

5885 Sunnybrook Dr
Ste L200
Sioux City, IA 51106
Phone (712) 239-4702

801 5th St
Ste 410
Sioux City, IA 51101
Phone (712) 239-4702

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

Interoperability endpoints

  • Direct secure messaging: ezajac128463@direct.unitypoint.org

Organizations & group practices 8

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.

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1265406060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3128",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511023128",
            "telephone_number": "712-239-4702",
            "fax_number": "712-224-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 SUNNYBROOK DR",
            "address_2": "SUITE L-200",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511064203",
            "telephone_number": "712-239-4702",
            "fax_number": "712-224-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "32426",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IA",
            "license": "32426",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NE",
            "license": "20824",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SD",
            "license": "4455",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172254",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.