Individual provider Active NPI

Colin M Zadikoff, MD

  • Neurology Physician
  • Cincinnati, OH
National Provider Identifier
1497865406
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
35-047648 Issued in OH
Practice address
4805 Montgomery Rd
Suite 410
Cincinnati, OH 45212-2198
Phone
(513) 241-2370
Fax
(513) 241-6053
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 35-047648 OH Primary

Addresses

Primary practice location

4805 Montgomery Rd
Suite 410
Cincinnati, OH 45212-2198

Mailing address

4805 Montgomery Rd
Suite 150
Cincinnati, OH 45212-2198
Phone (513) 961-5558

Other identifiers 9

IdentifierTypeStateIssuer
647879OtherAETNA
0498626MedicaidOH
200070330AMedicaidIN
311412447029OtherCARESOURCE
05-20156OtherUNITED HEALTHCARE
64781180MedicaidKY
5006431-002OtherCIGNA
000000019436OtherANTHEM
13889OtherNATIONWIDE HEALTH PLANS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-047648OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverhills Healthcare, Inc. Neurology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1497865406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 MONTGOMERY RD",
            "address_2": "SUITE 150",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122198",
            "telephone_number": "513-961-5558",
            "fax_number": "513-961-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 MONTGOMERY RD",
            "address_2": "SUITE 410",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122198",
            "telephone_number": "513-241-2370",
            "fax_number": "513-241-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADIKOFF",
        "first_name": "COLIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35-047648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "647879",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0498626",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200070330A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "311412447029",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "05-20156",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64781180",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5006431-002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000019436",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONWIDE HEALTH PLANS",
            "identifier": "13889",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.