Jack Matthew Zuckerman, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301503904 Issued in MI

Practice address

1221 Sixth St Ste 100
Traverse City, MI 49684-2359

Phone

(231) 935-0322

Fax

(231) 935-0334

NPI assigned

Jun 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, NC, CA, MI4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Urology

Education

Wake Forest University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Munson Healthcare Cadillac 104 clinicians

Northsport Physical Therapy and Rehabilitation P C 43 clinicians

Munson Medical Center 377 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
• Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
• Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300
• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jzuckerman@direct.mhc.net

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.

• Munson Healthcare Cadillac

  • Rural Health Clinic/Center
  • MC Bain, MI
  • NPI 1336539063

  MI

  Medicare reassignment Care Compare group NPD
• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860

  MI

  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942

  CA

  Medicare reassignment NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026

  VA

  Medicare reassignment NPD
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  Care Compare group NPD (past)
• Munson Healthcare Cadillac

  • Surgery Physician
  • Cadillac, MI
  • NPI 1336547041
  Care Compare group
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754
  Care Compare group
• Munson Healthcare Cadillac

  • Anesthesiology Physician
  • Cadillac, MI
  • NPI 1871991596
  Care Compare group
• Munson Healthcare Cadillac

  • Rural Health Clinic/Center
  • Cadillac, MI
  • NPI 1912303728
  Care Compare group
• Munson Medical Center

  • Rehabilitation Hospital Unit
  • Traverse City, MI
  • NPI 1104080621
  Care Compare group
• Munson Medical Center

  • Home Infusion Therapy Pharmacy
  • Traverse City, MI
  • NPI 1134205032
  Care Compare group
• Munson Medical Center

  • Specialty Pharmacy
  • Traverse City, MI
  • NPI 1194425447
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kalkaska Memorial Health Center

  • Critical Access Hospital
  • Kalkaska, MI
  • NPI 1497751309

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754

  Hospital

  Care Compare affiliation
• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972

  Hospital

  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852

  Hospital

  Care Compare affiliation
• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1508093428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 100",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-935-0322",
            "fax_number": "231-935-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 100",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-935-0322",
            "fax_number": "231-935-0334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11848 Rock Landing Dr Ste 402",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "23606",
            "country_code": "US",
            "telephone_number": "757-873-1347",
            "fax_number": "757-873-1612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-7200",
            "fax_number": "619-532-7234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 Park Forest Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847331",
            "country_code": "US",
            "telephone_number": "231-392-8900",
            "fax_number": "231-392-8973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 Sunnyside Dr",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496018735",
            "country_code": "US",
            "telephone_number": "231-779-2565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZUCKERMAN",
        "first_name": "JACK",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2016-02247",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101248101",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301503904",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "137309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Zokas, NP
• Eugene Zolotarevsky, MD
• Jonathan Bradley Zoutendam, DDS
• Peter Joseph Zoutendyk Jr., MSW
• Anastasiya Zubaryeva, PA-C
• Amanda Zuker, LMSW
• Anne Zwart, PA-C
• Jonathan Zywicki, NP

• All providers in Traverse City, MI
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.