Samuel Jacob Zidovetzki, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A155123 Issued in CA

Practice address

600 Highland Ave
H4/831
Madison, WI 53792

Phone

(608) 890-8682

NPI assigned

Apr 15, 2013

Last updated

Jul 26, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, CA2 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

Specialty

Emergency Medicine

Education

University of Southern California Keck School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Community Hospital Hospital, Riverside, CA, CCN 050022
• Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment Care Compare group NPD
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• Fpa Hospital Based

  • Nuclear Medicine Physician
  • New York, NY
  • NPI 1629319413
  Medicare reassignment NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Riverside, CA
  • NPI 1386750578
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Fpa Hospital Based

  dba FPA Hospital Based MSMC Emergency Physicians

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1427398676
  NPD
• Fpa Hospital Based

  dba Mount Sinai Dermatopathology Services III

  • Dermatopathology (Pathology) Physician
  • New York, NY
  • NPI 1841531795
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Los Angeles

  dba LAC Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1477574838
  Care Compare affiliation
• Riverside Healthcare System, L.P.

  dba Riverside Community Hospital

  • General Acute Care Hospital
  • Riverside, CA
  • NPI 1114971660
  Care Compare affiliation

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1427491968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "H4/831",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-890-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "H4/831",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53792",
            "telephone_number": "608-890-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIDOVETZKI",
        "first_name": "SAMUEL",
        "middle_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A155123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Igor O Zhukov, M.D.
• Dan Zia, DPT
• Lynnda L Zibell-Milsap, RN MS
• Allison Ziche, RBT
• Tamar Zick, MA LLC
• Amy Lee Ziegelbauer, CTRS
• Andrew J. Ziegert, M.D.
• Katherine Ziegert, MSSW, LCSW
• Crystal Louise Ziegler, PA-C
• Tiffany Ziegler, MS, LPC-IT, SAC-IT

• Emergency Medicine Physician in Madison, WI
• Providers in Madison, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.