Individual provider Active NPI

Jill Marie Zaske, NP

  • Family Nurse Practitioner
  • Flint, MI
National Provider Identifier
1396043493
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704257205 Issued in MI
Practice address
1345 Willowdale CT
Flint, MI 48532-4737
Phone
(810) 720-4130
Fax
(810) 720-4661
NPI assigned
Mar 14, 2011
Last updated
Mar 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704257205 MI Primary
Nurse Practitioner 363L00000X 4704257205 MI

Addresses

Primary practice location

1345 Willowdale CT
Flint, MI 48532-4737

Mailing address

1345 Willowdale CT
Flint, MI 48532-4737
Phone (810) 720-5130

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jzaske38550@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110505000291 MI Practitioner - Nurse Practitioner 0042495129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

700 Cooper Ave
Saginaw, MI 48602-5383
Phone (989) 583-4220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince Jul 16, 2015 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Jul 16, 2015 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients
Great Lakes Brain Spine Surgery and Pain Center PLLC PastSince Jan 19, 2016 Accepting new patients

Locations

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

Interoperability endpoints

  • Direct secure messaging: jzaske38550@direct.covenanthealthcare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1396043493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 WILLOWDALE CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324737",
            "telephone_number": "810-720-5130",
            "fax_number": "810-720-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 WILLOWDALE CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324737",
            "telephone_number": "810-720-4130",
            "fax_number": "810-720-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZASKE",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-14",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704257205",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704257205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jzaske38550@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "1345 Willowdale Ct",
            "city": "Flint",
            "state": "MI",
            "country_code": "US",
            "postal_code": "485324737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.