NPIMap

Individual provider Active NPI

Zackery Sira, M.D.

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1306290572
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101274868 Issued in VA
Practice address
82-68 164TH Street
Queens Hospital Center Dept of Internal Medicine
Jamaica, NY 11432
Phone
(718) 883-4080
NPI assigned
Apr 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2022-03326 NC
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 0101274868 VA Primary

Addresses

Primary practice location

82-68 164TH Street
Queens Hospital Center Dept of Internal Medicine
Jamaica, NY 11432

Mailing address

82-68 164TH Street
Queens Hospital Center Dept of Internal Medicine
Jamaica, NY 11432
Phone (718) 883-4080

Other practice location 1

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA, NC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190709000561 NY Practitioner - Internal Medicine 9739428491 Reassigns benefits to 1 organization
I20230301000308 VA Practitioner - Internal Medicine 9739428491 Reassigns benefits to 2 organizations
I20230309000974 NC Practitioner - Internal Medicine 9739428491 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-4380

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-8000

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-7597

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2022-03326NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Healthcare LLC Current Accepting new patients
Cogent Healthcare of North Carolina, PC Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Hospitalist CurrentSince Aug 1, 2024 Accepting new patients
Bladen Healthcare LLC CurrentSince May 29, 2023 Accepting new patients
Cumberland County Hospital System Inc CurrentSince May 29, 2023 Accepting new patients
Apogee Medical Group Virginia, PC Internal Medicine CurrentSince Dec 7, 2022 Accepting new patients
Bladen Healthcare, LLC Hospitalist CurrentSince May 29, 2023 Accepting new patients
Cumberland County Hospital System Inc Internal Medicine CurrentSince May 29, 2023 Accepting new patients
Usacs Integrated Acute Care Services of North Carolina, PLLC Internal Medicine CurrentSince Feb 26, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 3, 2024 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Delphi Hospitalist Services LLC Hospitalist CurrentSince Aug 1, 2019 Accepting new patients
Novant Health Medical Group, LLC Hospitalist CurrentSince Sep 3, 2024 Accepting new patients
Lake Spring Physician Services, LLC Hospitalist CurrentSince Nov 10, 2025 Accepting new patients
Moses Cone Physician Services Inc Hospitalist CurrentSince Feb 24, 2023 Accepting new patients
Moses Cone Physician Services, Inc. Internal Medicine Current Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

262 Leroy George Dr
Clyde, NC 28721
Phone (828) 452-8210

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: zsira1590281@direct.novanthealth.org
  • Direct secure messaging: zsira113405@capefearvalley.direct-ci.com
  • Direct secure messaging: zsira21747@carolinaeastmc.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1306290572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-68 164TH STREET",
            "address_2": "QUEENS HOSPITAL CENTER DEPT OF INTERNAL MEDICINE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-883-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82-68 164TH STREET",
            "address_2": "QUEENS HOSPITAL CENTER DEPT OF INTERNAL MEDICINE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "11432",
            "telephone_number": "718-883-4080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Silas Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271033013",
            "country_code": "US",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIRA",
        "first_name": "ZACKERY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-14",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2022-03326",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.