Individual provider Active NPI

Beverly M Zak, MD

  • Dermatology Physician
  • Nashville, TN
National Provider Identifier
1396892253
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD46224 Issued in TN
Practice address
4230 Harding Pike Ste 501
Nashville, TN 37205-2018
Phone
(629) 255-2132
Fax
(629) 255-4113
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD46224 TN Primary

Addresses

Primary practice location

4230 Harding Pike Ste 501
Nashville, TN 37205-2018

Mailing address

222 22ND Ave N
Nashville, TN 37203-1852
Phone (629) 255-3486

Other identifiers 1

IdentifierTypeStateIssuer
1520858MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20101214000513 TN Practitioner - Dermatology 4981891132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, San Diego School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heritage Medical Associates PCGroup PAC ID 4688651037, 162 clinicians

Practice addresses (Care Compare)

4230 Harding Pike
Suite 501
Nashville, TN 37205-2018
Phone (629) 255-2124

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions962
Removal or shaving of skin growth1-10
Skin biopsy209

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD46224TNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Medical Associates PC CurrentSince Jan 1, 2011 Accepting new patients
Heritage Medical Associates PC Dermatology CurrentSince Jan 1, 2011 Accepting new patients
Acacia Dermatology CurrentSince Oct 1, 2008 Accepting new patients

Locations

2131 N Locust Ave
Ste D
Lawrenceburg, TN 38464
Phone (931) 762-6545

4230 Harding Pike
Ste 501
Nashville, TN 37205
Phone (629) 255-2131

222 22nd Ave N
Nashville, TN 37203
Phone (629) 255-2620

Interoperability endpoints

  • Direct secure messaging: beverlyzak@hma.allscriptsdirect.net

Organizations & group practices 3

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1396892253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE STE 501",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052018",
            "telephone_number": "629-255-2132",
            "fax_number": "629-255-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK",
        "first_name": "BEVERLY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD46224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520858",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.