Active NPI
Zachariah D. Pranckun, DO
- Child & Adolescent Psychiatry Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- OS017826
- Practice address
- 1735 Market Street
Suite a #110
Philadelphia, PA 19103 - Phone
- (215) 995-4138
- Fax
- (980) 734-3069
- NPI assigned
- Apr 29, 2012
- Last updated
- May 13, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | H0097879 | MD | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 34.016626 | OH | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | OS017826 | PA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 25MB11510700 | NJ | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 4142 | WV | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | C20012359 | DE |
Addresses
Primary practice location
1735 Market Street
Suite a #110
Philadelphia, PA 19103
Mailing address
PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C20012359 | DE | MD | Child & Adolescent Psychiatry Physician |
| H0097879 | MD | MD | Child & Adolescent Psychiatry Physician |
| 25MB11510700 | NJ | MD | Child & Adolescent Psychiatry Physician |
| 34.016626 | OH | MD | Child & Adolescent Psychiatry Physician |
| OS017826 | PA | MD | Child & Adolescent Psychiatry Physician |
| 4142 | WV | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Virginia University Medical Corporation | Current | Accepting new patients | |
| Comprehensive Psychiatric Services, a Medical Group | Current | Accepting new patients | |
| West Virginia University Medical Corporation | Current | Accepting new patients |
Locations
6167 Bristol Pkwy
Ste 260
Culver City, CA 90230
Phone (424) 331-5604
16501 Ventura Blvd
Ste 400
Encino, CA 91436
Phone (818) 522-7369
145 S Fairfax Ave
Ste 200300
Los Angeles, CA 90036
Phone (909) 442-4965
3100 Oak Rd
Ste 270
Walnut Creek, CA 94597
Phone (925) 944-9711
1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500
930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Walnut Creek, CA
- NPI 1184785834
-
dba University Health Associates
- Family Medicine Physician
- Morgantown, WV
- NPI 1275504508
-
dba Crisis Support and Recovery Center
- Community/Behavioral Health Agency
- Martinsburg, WV
- NPI 1174233530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1326306267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-4000",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1735 MARKET STREET",
"address_2": "SUITE A #110",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19103",
"telephone_number": "215-995-4138",
"fax_number": "980-734-3069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRANCKUN",
"first_name": "ZACHARIAH",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-29",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MD",
"license": "H0097879",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "OH",
"license": "34.016626",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "PA",
"license": "OS017826",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NJ",
"license": "25MB11510700",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "WV",
"license": "4142",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "DE",
"license": "C20012359",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.