Individual provider Active NPI

Zdenek Otruba, MD

  • Anesthesiology Physician
  • Wenatchee, WA
National Provider Identifier
1265487367
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00039302 Issued in WA
Practice address
820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone
(509) 663-8711
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00039302 WA Primary

Addresses

Primary practice location

820 N Chelan Ave
Wenatchee, WA 98801-2028

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other identifiers 2

IdentifierTypeStateIssuer
1265487367MedicaidWA
P01378277OtherWARR MEDICARE PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/
Direct Messaging Address zotruba19184@edirect.chehr.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140813002780 WA Practitioner - Anesthesiology 4183612070 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

Hospital & facility affiliations

  • Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00039302WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Washington Health Services Association Current Accepting new patients
Wenatchee Valley Hospital Current Accepting new patients
Central Washington Health Services Association CurrentSince Aug 1, 2022 Accepting new patients
Wenatchee Valley Hospital CurrentSince Sep 1, 2014 Accepting new patients
Wenatchee Anesthesia Associates a Professional Corporation Anesthesiology Past Accepting new patients

Locations

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

Interoperability endpoints

  • Direct secure messaging: zotruba19184@edirect.chehr.org

Organizations & group practices 5

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 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1265487367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTRUBA",
        "first_name": "ZDENEK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00039302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265487367",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01378277",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "820 N Chelan Ave",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988012028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zotruba19184@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "820 N Chelan Ave",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988012028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.