NPIMap

Individual provider Active NPI

Heather Zimba, MD

  • Family Medicine Physician
  • Shawano, WI
National Provider Identifier
1487069068
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67718 Issued in WI
Practice address
100 County Road B
Shawano, WI 54166-7072
Phone
(715) 524-2161
Fax
(715) 524-8164
NPI assigned
Jun 23, 2014
Sex
Female
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 67718 WI Primary

Addresses

Primary practice location

100 County Road B
Shawano, WI 54166-7072

Mailing address

PO Box 8003
Appleton, WI 54912-8003
Phone (920) 830-5900

Other practice location 1

551 S Park St
Casper, WY 82601-3336
Phone (607) 398-4404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230127002567 NY Practitioner - Family Practice 5799904330 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cayuga Medical Center at IthacaGroup PAC ID 7214847367, 34 clinicians
Schuyler Hospital IncGroup PAC ID 3577548262, shared by 6 NPIs, 41 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4443

2138 W Seneca St
Ovid Primary Care Center
Ovid, NY 14521-9701
Phone (607) 869-2541

220 Steuben St
Montour Falls, NY 14865-9740
Phone 607535863952353

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
82.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
67718WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Center at Ithaca CurrentSince Feb 1, 2023 Accepting new patients
Schuyler Hospital Inc Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Schuyler Hospital Inc CurrentSince Jan 14, 2026 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients
Schuyler Hospital Inc CurrentSince Jan 1, 2023 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Feb 1, 2023 Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

2138 W Seneca St
Ovid, NY 14521
Phone (607) 869-2541

Interoperability endpoints

  • Direct secure messaging: hzimba529226@wm.providencedirect.org
  • Direct secure messaging: hzimba182348@direct.thedacare.org
  • Direct secure messaging: hzimba27370@direct.xtensys.com

Organizations & group practices 6

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487069068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-830-5900",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-524-2161",
            "fax_number": "715-524-8164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "551 S Park St",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826013336",
            "country_code": "US",
            "telephone_number": "607-398-4404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIMBA",
        "first_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "67718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

Verify at the official NPI Registry.