Zackery J Tegge, MCMS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4320 Issued in WI

Practice address

4007 Estate Diamond Ruby
Christiansted, VI 00820

Phone

(340) 778-6311

NPI assigned

Mar 31, 2017

Last updated

Apr 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DLP Marquette Physician Practices IncGroup PAC ID 9931359601, 193 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zackery.tegge.1@8233.direct.athenahealth.com

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.

• DLP Marquette Physician Practices Inc

  dba Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995
  Medicare reassignment Care Compare group
• DLP Marquette Physician Practices Inc

  dba UP Health System Pediatric Specialists

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• DLP Marquette Physician Practices Inc

  dba Marquette General Occupational Medicine

  • Occupational Medicine Physician
  • Marquette, MI
  • NPI 1265780621
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Marquette General Hospital LLC

  dba UP Health System Marquette

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  Care Compare affiliation

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1366974123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 ESTATE DIAMOND RUBY",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00820",
            "telephone_number": "340-778-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4007 Estate Diamond Ruby",
            "address_purpose": "LOCATION",
            "city": "Christiansted",
            "state": "VI",
            "postal_code": "008204435",
            "country_code": "US",
            "telephone_number": "340-778-6311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "920-288-4060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Two Rivers",
            "state": "WI",
            "postal_code": "542413900",
            "country_code": "US",
            "telephone_number": "920-794-5125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEGGE",
        "first_name": "ZACKERY",
        "middle_name": "J",
        "credential": "MCMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100077680",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ztegge200075@aurora.direct-ci.com",
            "affiliation": "N",
            "address_1": "5000 Memorial Dr",
            "city": "Two Rivers",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542413900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Superior Medical DME & Supplies LLC
• Superior Supplies
• Surgical Choice
• Anna Sylvia
• Jan B Tawakol, M.D.
• Templeworks Wellness & Therapeutics
• The Guy Alexander Ambulatory Medicine Academy
• The Heart Center PC
• The Prevention Specialists LLC
• The Rubin Heart Clinic LLC

• Physician Assistant in Christiansted, VI
• Providers in Christiansted, VI by specialty
• Physician Assistant in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.

Verify at the official NPI Registry.