Olivia Zaczyk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10003960A Issued in IN

Practice address

14785 W 101St Ave Ste 2a
Dyer, IN 46311-3371

Phone

(219) 228-4200

NPI assigned

Mar 15, 2023

Last updated

Apr 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 IN

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermio Dermatology LLCGroup PAC ID 7315206687, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Dermio Dermatology, LLC

  • Dermatology Physician
  • Munster, IN
  • NPI 1811402423
  Medicare reassignment Care Compare group
• Dermio Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Munster, IN
  • NPI 1346072139
  NPD (past)

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1477254639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779203",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779203",
            "telephone_number": "219-228-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14785 W 101ST AVE STE 2A",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463113371",
            "telephone_number": "219-228-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACZYK",
        "first_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003960A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy A Wright, LCPC LMFT LMHC
• Shahnour Yaylayan, MD
• Young Mindz Neuro Clinic LLC
• Haylie R Young
• Leena Yousef-Diaz, APN
• Robert Zajac, D.D.S
• Azkaa Zaman, DO
• Jessica Zandy
• Fithun Lulseged Zekarias, MD
• Ozair M Ziauddin, M.D.

• Physician Assistant in Dyer, IN
• Providers in Dyer, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.