Individual provider Active NPI

Zachary Adam Zimmerman, M.D.

  • Otolaryngology Physician
  • Beloit, WI
National Provider Identifier
1265815187
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
75795-20 Issued in WI
Practice address
Beloit Clinic
1905 E Huebbe Parkway
Beloit, WI 53511-1842
Phone
(608) 364-2400
Fax
(608) 363-7376
NPI assigned
Jul 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 7590 GA
Otolaryngology Physician 207Y00000X 036-151049 IL
Facial Plastic Surgery Physician 207YS0123X 036151049 IL
Facial Plastic Surgery Physician 207YS0123X 036-151049 IL
Facial Plastic Surgery Physician 207YS0123X 75795-20 WI
Otolaryngology Physician 207Y00000X 75795-20 WI Primary

Addresses

Primary practice location

Beloit Clinic
1905 E Huebbe Parkway
Beloit, WI 53511-1842

Mailing address

Beloit Health System
1905 E. Huebbe Parkway
Beloit, WI 53511-1842
Phone (608) 364-2400

Other practice location 1

1120 15th St
Augusta, GA 30912-0004
Phone (706) 721-4307

Other identifiers 2

IdentifierTypeStateIssuer
100175684MedicaidWI
7590OtherFLGEORGIA COMPOSITE MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200519003162 IL Practitioner - Otolaryngology 4385075779 Reassigns benefits to 1 organization
I20210803000695 WI Practitioner - Otolaryngology 4385075779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Florida College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, shared by 4 NPIs, 138 clinicians

Practice addresses (Care Compare)

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 364-2200

5605 E Rockton Rd
Roscoe, IL 61073-7641
Phone (815) 525-4930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision13
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7590GAMDOtolaryngology Physician
036-151049ILMDOtolaryngology Physician
036151049ILMDFacial Plastic Surgery Physician
75795-20WIMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System Inc CurrentSince Jul 1, 2021 Accepting new patients
Beloit Clinic, S.C. Otolaryngology Current Accepting new patients
Beloit Health System Inc CurrentSince Jul 1, 2021 Accepting new patients
Beloit Health System, Inc CurrentSince Jul 1, 2021 Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1265815187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BELOIT HEALTH SYSTEM",
            "address_2": "1905 E. HUEBBE PARKWAY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2400",
            "fax_number": "608-363-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BELOIT CLINIC",
            "address_2": "1905 E HUEBBE PARKWAY",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2400",
            "fax_number": "608-363-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120004",
            "country_code": "US",
            "telephone_number": "706-721-4307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "ZACHARY",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2023-09-07",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "7590",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036-151049",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "IL",
            "license": "036151049",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "IL",
            "license": "036-151049",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WI",
            "license": "75795-20",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "75795-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100175684",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA COMPOSITE MEDICAL BOARD",
            "identifier": "7590",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.