NPIMap

Individual provider Active NPI

Nikki Zybach, P.A.

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1457565988
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1104 Issued in OK
Practice address
210 SW 89TH St
Oklahoma City, OK 73139-8503
Phone
(405) 631-0663
Fax
(405) 631-7047
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1104 OK Primary

Addresses

Primary practice location

210 SW 89TH St
Oklahoma City, OK 73139-8503

Mailing address

210 SW 89TH St
Oklahoma City, OK 73139-8532
Phone (405) 631-0663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223000711 OK Practitioner - Physician Assistant 4981909355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edmond Urgent Care Inc.Group PAC ID 0547494254, 4 clinicians
Ronald R. Hopkins, D.O., PLLCGroup PAC ID 7517142136, 3 clinicians

Practice addresses (Care Compare)

1101 NW 178TH St
Suite B
Edmond, OK 73012-4281
Phone (405) 285-2161

210 S W 89TH St
Oklahoma City, OK 73139-8532

210 SW 89TH St
Oklahoma City, OK 73139-8532
Phone (405) 631-0663

Hospital & facility affiliations

  • Oklahoma Center for Orthopaedic & Multi-SP Hospital, Oklahoma City, OK, CCN 370212
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Integris Southwest Medical Center Hospital, Oklahoma City, OK, CCN 370106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1104OKMDRegistered Dietitian
PA1104OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Urgent Care LLC PastSince Apr 26, 2020 Accepting new patients
Summit Medical Center Past Accepting new patients

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 5

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1457565988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SW 89TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731398532",
            "telephone_number": "405-631-0663",
            "fax_number": "405-631-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SW 89TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731398503",
            "telephone_number": "405-631-0663",
            "fax_number": "405-631-7047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYBACH",
        "first_name": "NIKKI",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA1104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.