Individual provider Active NPI

Zachary Tye Taylor, PA

  • Physician Assistant
  • Fairbanks, AK
National Provider Identifier
1306667746
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1606 23Rd Ave
Fairbanks, AK 99701-6407
Phone
(907) 455-4567
NPI assigned
Oct 18, 2024
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1606 23Rd Ave
Fairbanks, AK 99701-6407

Mailing address

1606 23Rd Ave
Fairbanks, AK 99701-6407
Phone (907) 455-4567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251216004962 TX Practitioner - Physician Assistant 8325573942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interior Community Health CenterGroup PAC ID 9830001031, shared by 2 NPIs, 6 clinicians
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

1606 23Rd Ave
Fairbanks, AK 99701-6407
Phone (907) 455-4567

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

Main St
Rampart, AK 99767-9998
Phone (907) 451-6682

Usibelli Spur Rd
Healy, AK 99743-0246
Phone (907) 683-2211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference CurrentSince Jan 5, 2026 Accepting new patients
Tanana Chiefs Conference CurrentSince Jan 5, 2026 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: zachary.taylor.1@21673.direct.athenahealth.com

Organizations & group practices 2

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 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": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1306667746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 23RD AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016407",
            "telephone_number": "907-455-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 23RD AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016407",
            "telephone_number": "907-455-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ZACHARY",
        "middle_name": "TYE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.