Individual provider Active NPI

Kenneth Edward Zigrosser, PA

  • Physician Assistant
  • Albany, NY
National Provider Identifier
1386797983
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117585 Issued in FL
Practice address
400 Patroon Creek Blvd
Suite 100
Albany, NY 12206-5013
Phone
(518) 445-4444
Fax
(518) 618-1665
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002284 NY
Physician Assistant 363A00000X PA9117585 FL Primary

Addresses

Primary practice location

400 Patroon Creek Blvd
Suite 100
Albany, NY 12206-5013

Mailing address

400 Patroon Creek Blvd
Suite 100
Albany, NY 12206-5013
Phone (518) 445-4444

Other identifiers 2

IdentifierTypeStateIssuer
00553OtherWVLICENSE
002284OtherNYMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070822000231 NY Practitioner - Physician Assistant 9436251626 Reassigns benefits to 1 organization
I20231029000090 FL Practitioner - Physician Assistant 9436251626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

10650 SW Tradition Pkwy
Port Saint Lucie, FL 34987-2862
Phone (772) 241-6840

1730 SW Saint Lucie W Blvd
Port Saint Lucie, FL 34986-2504
Phone (772) 873-8155

1900 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5554
Phone (772) 398-1588

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

640 21St St
Vero Beach, FL 32960-0933
Phone (772) 299-1092

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
553WVMDCounselor
002284NYMDDiagnostic Radiology Physician
PA9117585FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jun 11, 2007 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jun 11, 2007 Accepting new patients
MD Now Medical Centers Inc CurrentSince Nov 20, 2023 Accepting new patients

Locations

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

130 North St
Walton, NY 13856
Phone (607) 865-6541

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: kzigrosser1637@bassett.direct-ci.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1386797983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-445-4444",
            "fax_number": "518-618-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PATROON CREEK BLVD",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122065013",
            "telephone_number": "518-445-4444",
            "fax_number": "518-618-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIGROSSER",
        "first_name": "KENNETH",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002284",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "00553",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "002284",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.