Zachary N Bastian, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M-12152 Issued in ID

Practice address

1024 E Locust St
Emmett, ID 83617-2776

Phone

(208) 365-2338

Fax

(208) 365-0677

NPI assigned

Jun 26, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/eb237299-e2be-4fd4-aca6-5fa7adcd28c1/
• Direct secure messaging: zbastian@valorhealth.cernerdirect.com
• Direct secure messaging: zachb@yourcarecommunity.org

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.

• Walter Knox Memorial Hospital

  • Critical Access Hospital
  • Emmett, ID
  • NPI 1063419018

  ID

  Medicare reassignment NPD
• Walter Knox Memorial Hospital

  • Specialist
  • Emmett, ID
  • NPI 1326206947

  Surgery

  NPD
• Walter Knox Memorial Hospital

  • Family Medicine Physician
  • Emmett, ID
  • NPI 1861284721
  NPD

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1447412929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 E LOCUST ST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172776",
            "telephone_number": "208-365-2338",
            "fax_number": "208-365-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 E LOCUST ST",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836172776",
            "telephone_number": "208-365-2338",
            "fax_number": "208-365-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "ZACHARY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "RL10648",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "12284",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD165259",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M-12152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alan Robert Benson, CRNA
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• Malerie Erin Bettfreund, LMSW
• Black Canyon Dental P C
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• All providers in Emmett, ID
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.