Active NPI
Brian Joseph Zeithaml, M.D.
- Surgery Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD60848138
- Practice address
- 505 NE 87TH Ave Ste 301
Vancouver, WA 98664-1965 - Phone
- (360) 514-1854
- NPI assigned
- Jun 28, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2017-00874 | NC | |
| Surgical Critical Care Physician | 2086S0102X | MD60848138 | WA | |
| Surgery Physician | 208600000X | MD60848138 | WA | Primary |
Addresses
Primary practice location
505 NE 87TH Ave Ste 301
Vancouver, WA 98664-1965
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other practice location 1
517 Moye Blvd
Greenville, NC 27834-2849
Phone (252) 847-4299
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19R6U | Other | NC | BCBS OF NC |
| NCY144A | Other | NC | MEDICARE |
| 1366738312 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of North Carolina at Chapel Hill School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
505 NE 87TH Ave
Vancouver, WA 98664-1965
8821 NE 5TH St
Vancouver, WA 98664-3200
Phone (360) 514-1900
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017-00874 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Surgery | Current | Accepting new patients |
| Peacehealth | Past | Accepting new patients |
Locations
505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854
1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100
1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba PeaceHealth Southwest Medical Center
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba PeaceHealth SW Heart & Vascular Center
- Cardiovascular Disease Physician
- Vancouver, WA
- NPI 1003194911
Hospital
-
dba PeaceHealth Southwest Medical Center
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1366738312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 NE 87TH AVE STE 301",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986641965",
"telephone_number": "360-514-1854"
}
],
"practiceLocations": [
{
"address_1": "517 Moye Blvd",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "NC",
"postal_code": "278342849",
"country_code": "US",
"telephone_number": "252-847-4299",
"fax_number": "252-847-8208",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZEITHAML",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-28",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "2017-00874",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "WA",
"license": "MD60848138",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD60848138",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "19R6U",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "NCY144A",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1366738312",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.