Individual provider Active NPI

Mary Nasry Zaki, MD

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1346565611
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
125-058414 Issued in IL
Practice address
1740 W. Taylor
Chicago, IL 60612
Phone
(866) 600-2273
NPI assigned
Mar 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A129911 CA
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 125-058414 IL Primary

Addresses

Primary practice location

1740 W. Taylor
Chicago, IL 60612

Mailing address

2727 Eastlake Ave E Apt 208
Seattle, WA 98102-3141
Phone (503) 332-2390

Other names 1

  • Mary Hany Nasty Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20140630000862 CA Practitioner - Obstetrics/Gynecology 3072738376 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A129911CAMDObstetrics & Gynecology Physician
125-058414ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 17, 2016 Accepting new patients
University of California Irvine CurrentSince Mar 1, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 20, 2024 Accepting new patients
Regents of the University of California Obstetrics & Gynecology CurrentSince Jun 1, 2014 Accepting new patients
University of California Irvine CurrentSince Mar 1, 2016 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 17, 2016 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients
Magella Medical Group, Inc. Obstetrics & Gynecology Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

300 W Carl Karcher Way
Anaheim, CA 92801
Phone (657) 282-6356

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

200 S Manchester Ave
Ste 600
Orange, CA 92868
Phone (714) 456-2911

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1346565611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 EASTLAKE AVE E APT 208",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023141",
            "telephone_number": "503-332-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W. TAYLOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKI",
        "first_name": "MARY",
        "middle_name": "NASRY",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A129911",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125-058414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "CAREQUALITY",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "NASTY",
            "middle_name": "HANY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.