Individual provider Active NPI

Anna Halley Zivkovich, MD

  • Internal Medicine Physician
  • Kettering, OH
National Provider Identifier
1285828863
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.096376 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 384-6800
Fax
(937) 384-6939
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.096376 OH Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 35.096376 OH

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

2200 Miami Valley Drive
Dayton, OH 45459
Phone (937) 668-7873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120328000654 OH Practitioner - Internal Medicine 5799945747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia University School of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Vitas Solutions IncGroup PAC ID 7012087166, 55 clinicians

Practice addresses (Care Compare)

3055 Kettering Blvd
Suite 320
Moraine, OH 45439-1981
Phone (937) 299-5379

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Ohio Hospice, Cincinnati, OH, CCN 361562
  • Kettering Health Dayton Hospital, Dayton, OH, CCN 360133

Merit-based Incentive Payment System (MIPS)

Final score
62.04 of 100Reported as group
Quality
29.8
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.096376OHMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Healthcare LLC Hospice and Palliative Medicine CurrentSince Jul 17, 2016 Accepting new patients
The Hospice of Dayton, Inc. Hospice and Palliative Medicine CurrentSince Jan 8, 2012 Accepting new patients

Locations

7575 Paragon Rd
Dayton, OH 45459
Phone (937) 256-4490

2200 Miami Valley Dr
Dayton, OH 45459
Phone (937) 668-7873

324 Wilmington Ave
Kettering, OH 45420
Phone (937) 256-4490

Organizations & group practices 3

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 2

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1285828863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MIAMI VALLEY DRIVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-668-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIVKOVICH",
        "first_name": "ANNA",
        "middle_name": "HALLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.096376",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "OH",
            "license": "35.096376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.