Individual provider Active NPI

Paul Zajac, MD

  • Emergency Medicine Physician
  • Odessa, TX
National Provider Identifier
1407038748
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
246520 Issued in NY
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-4000
Fax
(214) 712-2487
NPI assigned
Nov 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 246520 NY Primary
Emergency Medicine Physician 207P00000X TEMP TX

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

310 E 24TH St
Apt. 6L
New York, NY 10010-4012
Phone (917) 403-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080401000873 TX Practitioner - Emergency Medicine 1153408190 Reassigns benefits to 2 organizations
I20190909000241 NY Practitioner - Emergency Medicine 1153408190 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
246520NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Basin Emergency Physicians PLLC Emergency Medicine CurrentSince Apr 1, 2009 Accepting new patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine Current Accepting new patients
Physicians Medical Associates New York PC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Trans Pecos Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1407038748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 24TH ST",
            "address_2": "APT. 6L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104012",
            "telephone_number": "917-403-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-4000",
            "fax_number": "214-712-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "246520",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "TEMP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.