Active NPI
Joseph Zikry, M.D.
- Dermatology Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- A159681
- Practice address
- 1811 Wilshire Blvd Ste 110
Santa Monica, CA 90403-5626 - Phone
- (310) 829-0260
- NPI assigned
- May 2, 2017
- Reactivated
- Jun 27, 2018
- Last updated
- Mar 23, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Dermatology Physician | 207N00000X | A159681 | CA | Primary |
Addresses
Primary practice location
1811 Wilshire Blvd Ste 110
Santa Monica, CA 90403-5626
Mailing address
1811 Wilshire Blvd Ste 110
Santa Monica, CA 90403-5626
Phone (310) 829-0260
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of California, Irvine, California College of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12555 W Jefferson Blvd
Los Angeles, CA 90066-7032
1811 Wilshire Blvd
Santa Monica, CA 90403-5626
2336 Santa Monica Blvd
Suite 204
Santa Monica, CA 90404-2938
Phone (310) 829-6789
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 96.07
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 69 |
| Removal of skin lesions | 1463 |
| Removal or shaving of skin growth | 11 |
| Skin biopsy | 499 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A159681 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Providence Saint Johns Medical Foundation | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Providence Saint John's Health Center | Past | Accepting new patients | |
| Saint John's Health Clinic | Past | Accepting new patients |
Locations
25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111
12555 W Jefferson Blvd
#301
Los Angeles, CA 90066
Phone (424) 443-5555
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
1811 Wilshire Blvd
Ste 110
Santa Monica, CA 90403
Phone (310) 453-9010
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477
8700 Beverly Blvd
Ste 5512
West Hollywood, CA 90048
Phone (310) 423-2811
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- jzikry1665190@oc.providencedirect.org
Organizations & group practices 6
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 Saint John's Physician Partners
- Specialist
- Santa Monica, CA
- NPI 1770093734
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Hawthorne, CA
- NPI 1164914115
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1124026273
-
dba Providence Saint John's Health Clinic
- Specialist
- Santa Monica, CA
- NPI 1336438902
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Santa Monica, CA
- NPI 1124026273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1366978918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 WILSHIRE BLVD STE 110",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904035626",
"telephone_number": "310-829-0260",
"fax_number": "310-829-0263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 WILSHIRE BLVD STE 110",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904035626",
"telephone_number": "310-829-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIKRY",
"first_name": "JOSEPH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-02",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"deactivation_date": "2018-06-11",
"reactivation_date": "2018-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "A159681",
"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": "25825 Vermont Ave",
"city": "Harbor City",
"state": "CA",
"country_code": "US",
"postal_code": "907103518",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.