Individual provider Active NPI

Zachary H Kim, PA

  • Physician Assistant
  • Sellersville, PA
National Provider Identifier
1346817848
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA062444 Issued in PA
Practice address
915 Lawn Ave
Sellersville, PA 18960-1551
Phone
(215) 257-3700
NPI assigned
Jun 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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 MA062444 PA Primary

Addresses

Primary practice location

915 Lawn Ave
Sellersville, PA 18960-1551

Mailing address

30 Kantner LN
Reading, PA 19607-9439
Phone (484) 797-5370

Other practice location 1

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20221024000032 NJ Practitioner - Physician Assistant 7012312879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Health Multispecialty GroupGroup PAC ID 1850689894, 342 clinicians

Practice addresses (Care Compare)

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 394-6000

Hospital & facility affiliations

  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • Capital Health Regional Medical Center Hospital, Trenton, NJ, CCN 310092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mordecai & Caravello Wellness, LLC Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1346817848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 KANTNER LN",
            "city": "READING",
            "state": "PA",
            "postal_code": "196079439",
            "telephone_number": "484-797-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 LAWN AVE",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601551",
            "telephone_number": "215-257-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Capital Way",
            "address_purpose": "LOCATION",
            "city": "Pennington",
            "state": "NJ",
            "postal_code": "085342520",
            "country_code": "US",
            "telephone_number": "609-303-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ZACHARY",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sellersville, PA

Sources for this page

Verify at the official NPI Registry.