Individual provider Active NPI

Michael Zicarelli, PA-C

  • Physician Assistant
  • Mountain BRK, AL
National Provider Identifier
1366106627
Registry record updated Oct 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1873 Issued in AL
Practice address
4 Norman Dr
Mountain BRK, AL 35213-4310
Phone
(205) 515-5657
NPI assigned
Oct 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2021

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 1873 AL Primary

Addresses

Primary practice location

4 Norman Dr
Mountain BRK, AL 35213-4310

Mailing address

4 Norman Dr
Mountain BRK, AL 35213-4310
Phone (205) 515-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220217001333 AL Practitioner - Physician Assistant 7911390885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2000 6TH Ave S
Birmingham, AL 35233-2110
Phone (205) 937-9999

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1873ALMDGeneral Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Feb 1, 2022 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

Interoperability endpoints

  • Direct secure messaging: mjzicarelli@direct.uabmedicine.org

Organizations & group practices 1

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.

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": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634947200000",
    "number": "1366106627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NORMAN DR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352134310",
            "telephone_number": "205-515-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NORMAN DR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352134310",
            "telephone_number": "205-515-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZICARELLI",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-23",
        "last_updated": "2021-10-23",
        "certification_date": "2021-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "1873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain BRK, AL

Sources for this page

Verify at the official NPI Registry.