Mark Zimmerman, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

97-414 Issued in NM

Practice address

5967 Sun Appello Ave
Las Vegas, NV 89122-3447

Phone

(702) 489-5120

Fax

(702) 489-5120

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Care Level Management Arizona, Inc

  • General Practice Physician
  • Phoenix, AZ
  • NPI 1578677993
  NPD (past)

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1376514646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5967 SUN APPELLO AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891223447",
            "telephone_number": "702-489-5120",
            "fax_number": "702-489-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5967 SUN APPELLO AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891223447",
            "telephone_number": "702-489-5120",
            "fax_number": "702-489-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NM",
            "license": "97-414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "953944",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree Zimmerman
• Edward M Zimmerman, M.D.
• Jessica Nicole Zimmerman, THERAPIST
• Leza Zimmerman
• Luella Zimmerman
• Michael S. Zimmerman, M.D.
• Sally Zimmerman
• Toni Zimmerman
• Wesley R. Zimmerman, CST/CSFA
• Adrianna Wechsler Zimring, PH.D.

• Geriatric Medicine (Internal Medicine) Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Geriatric Medicine (Internal Medicine) Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.