Individual provider Active NPI

Peter Ryan Zayac, PA

  • Surgical Physician Assistant
  • Pittsfield, MA
National Provider Identifier
1477075968
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA6162 Issued in MA
Practice address
24 Park St
Pittsfield, MA 01201-4037
Phone
(413) 499-6600
NPI assigned
Jul 17, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA6162 MA Primary

Addresses

Primary practice location

24 Park St
Pittsfield, MA 01201-4037

Mailing address

24 Park St
Pittsfield, MA 01201-4037
Phone (413) 499-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20171018000661 MA Practitioner - Physician Assistant 0941576094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

24 Park St
Pittsfield, MA 01201-0900
Phone (413) 499-6600

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6162MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Orthopaedic Associates, Inc. CurrentSince Aug 1, 2017 Accepting new patients

Locations

24 Park St
Pittsfield, MA 01201
Phone (413) 499-6600

Organizations & group practices 2

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.

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477075968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PARK ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014037",
            "telephone_number": "413-499-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PARK ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014037",
            "telephone_number": "413-499-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAYAC",
        "first_name": "PETER",
        "middle_name": "RYAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.