Individual provider Active NPI

Gene Wayne Zdenek, M.D.

  • Ophthalmology Physician
  • Reseda, CA
National Provider Identifier
1326104514
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
C39161 Issued in CA
Practice address
7012 Reseda Blvd
Suite B
Reseda, CA 91335-4219
Phone
(818) 708-2222
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C39161 CA Primary

Addresses

Primary practice location

7012 Reseda Blvd
Suite B
Reseda, CA 91335-4219

Mailing address

7012 Reseda Blvd
Suite B
Reseda, CA 91335-4219
Phone (818) 708-2222

Other identifiers 1

IdentifierTypeStateIssuer
00C391610MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110613000854 CA Practitioner - Ophthalmology 7618159880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rush Medical College of Rush University, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7012 Reseda Blvd
Suite B
Reseda, CA 91335-4274
Phone (818) 708-2222

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C39161CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optical Reflections Ophthalmology Current Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

7012 Reseda Blvd
Ste B
Reseda, CA 91335
Phone (818) 708-2222

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1326104514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 RESEDA BLVD",
            "address_2": "SUITE B",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354219",
            "telephone_number": "818-708-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 RESEDA BLVD",
            "address_2": "SUITE B",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354219",
            "telephone_number": "818-708-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDENEK",
        "first_name": "GENE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "C39161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C391610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

Verify at the official NPI Registry.