Individual provider Active NPI

Zachariah D. Pranckun, DO

  • Child & Adolescent Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1326306267
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
OS017826 Issued in PA
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230818002804 WV Practitioner - Psychiatry 2264741842 Reassigns benefits to 1 organization
I20250130002662 CA Practitioner - Psychiatry 2264741842 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C20012359DEMDChild & Adolescent Psychiatry Physician
H0097879MDMDChild & Adolescent Psychiatry Physician
25MB11510700NJMDChild & Adolescent Psychiatry Physician
34.016626OHMDChild & Adolescent Psychiatry Physician
OS017826PAMDChild & Adolescent Psychiatry Physician
4142WVMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Aug 1, 2023 Accepting new patients
Comprehensive Psychiatric Services, a Medical Group CurrentSince Jan 1, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 1, 2023 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.

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

Verify at the official NPI Registry.