Individual provider Active NPI

Jeffrey M Zaks, M.D.

  • Cardiovascular Disease Physician
  • Southfield, MI
National Provider Identifier
1396746806
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301033645 Issued in MI
Practice address
22250 Providence Dr
705
Southfield, MI 48075-4825
Phone
(248) 552-9858
Fax
(248) 552-9510
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301033645 MI Primary

Addresses

Primary practice location

22250 Providence Dr
705
Southfield, MI 48075-4825

Mailing address

22250 Providence Dr
Suite 705
Southfield, MI 48075-4825
Phone (248) 552-9858

Other identifiers 1

IdentifierTypeStateIssuer
193549410MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000633 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7012088461 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital Current Accepting new patients
Henry Ford Health Providence Hospital CurrentSince May 1, 2017 Accepting new patients
Henry Ford Health Providence Hospital Cardiovascular Disease CurrentSince May 1, 2017 Accepting new patients
Henry Ford Health Providence Hospital Current Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

1225 S Latson Rd
Ste 230
Howell, MI 48843
Phone (517) 548-7777

26850 Providence Pkwy
Ste 205
Novi, MI 48374
Phone (248) 465-3144

22250 Providence Dr
Ste 705
Southfield, MI 48075
Phone (248) 465-5955

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

16001 W 9 Mile Rd
Fl 5
Southfield, MI 48075
Phone (248) 380-4335

Interoperability endpoints

  • Direct secure messaging: dr_zaks@heartcardiologyconsultants.ssdirect.aprima.com
  • Direct secure messaging: jzaks1158599@direct.hfhs.org

Organizations & group practices 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1396746806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-552-9858",
            "fax_number": "248-552-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-552-9858",
            "fax_number": "248-552-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKS",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301033645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193549410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.