Individual provider Active NPI

Evelyn Zaky, MD

  • Anesthesiology Physician
  • Staten Island, NY
National Provider Identifier
1417955683
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
214005-1 Issued in NY
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-2000
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 214005-1 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

PO Box 10049
New York, NY 10259-0049
Phone (201) 804-2800

Other identifiers 1

IdentifierTypeStateIssuer
018997305MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090526000248 NY Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 8921157819 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

404 Potter Blvd
Brightwaters, NY 11718-1830
Phone (914) 666-8866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000709NYMDMetabolic Nutrition Registered Dietitian
214005-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Nov 1, 2016 Accepting new patients
Physicians of University Hospital, PC Anesthesiology CurrentSince Nov 1, 2016 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients
TJH Medical Services, P.C. Anesthesiology Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

404 Potter Blvd
Brightwaters, NY 11718
Phone (631) 376-0055

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1417955683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10049",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102590049",
            "telephone_number": "201-804-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKY",
        "first_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "214005-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018997305",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.