Zaccariah Desmond Ivy, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.0003256 Issued in CO

Practice address

13123 E 16TH Ave
Aurora, CO 80045-7106

Phone

(720) 777-1234

NPI assigned

Aug 10, 2011

Last updated

Aug 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zivy34846@direct.childrenscolorado.org

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.

• University Physicians Incorporated

  dba CU Medicine

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1962461889

  Physician Assistant

  Medicare reassignment NPD (past)
• Children's Hospital Colorado

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1174282776
  NPD
• University Physicians Incorporated

  dba Children's Hospital Colorado - Colorado Springs

  • Pediatrics Physician
  • Colorado Springs, CO
  • NPI 1346744083
  NPD
• University Physicians, Incorporated

  dba CU Sports Medicine Colorado Center

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1275045049
  NPD

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1407135205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14000 E Arapahoe Rd",
            "address_2": "#300",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801124043",
            "country_code": "US",
            "telephone_number": "720-979-0840",
            "fax_number": "303-861-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVY",
        "first_name": "ZACCARIAH",
        "middle_name": "DESMOND",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003256",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0003256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Marie Iverson
• Laurie C Ivey, PSYD
• Connor Ivnoff
• Ivory Assisted Living, LLC
• David Ivy, MD
• Sean J Iwamoto, MD
• Masayo Iwate, LCSW
• Lauretta Iwuala -McWilliams, NP-C
• Samantha Izat, MSN, FNP-BC
• Fatima Izno

• Medical Physician Assistant in Aurora, CO
• Providers in Aurora, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.