Individual provider Active NPI

Ralph Joseph Zwolinski, MD

  • Neurology Physician
  • Port Orange, FL
National Provider Identifier
1528049327
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME 46005 Issued in FL
Practice address
5111 S Ridgewood Ave
Suite 102
Port Orange, FL 32127-5169
Phone
(386) 763-4484
Fax
(386) 763-1288
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 000046005 FL
Neurology Physician 2084N0400X ME 46005 FL Primary
Pain Medicine Physician 208VP0000X ME 46005 FL
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X NE 46005 FL

Addresses

Primary practice location

5111 S Ridgewood Ave
Suite 102
Port Orange, FL 32127-5169

Mailing address

1673 Mason Ave
Suite 107
Daytona Beach, FL 32117-5515
Phone (386) 274-7118

Other identifiers 3

IdentifierTypeStateIssuer
64543OtherFLBC/BS
098653400MedicaidFM
P00827133OtherFLRAILROAD MEDICARE

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
000046005FLMDSpecialist
28844FLMDPhysical Medicine & Rehabilitation Physician
ME 46005FLMDNeurology Physician
NE 46005FLMDPain Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology & Spine Disorders LLC Neurology Past Accepting new patients
Halifax Healthcare Systems Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1528049327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 MASON AVE",
            "address_2": "SUITE 107",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175515",
            "telephone_number": "386-274-7118",
            "fax_number": "386-274-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 S RIDGEWOOD AVE",
            "address_2": "SUITE 102",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321275169",
            "telephone_number": "386-763-4484",
            "fax_number": "386-763-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWOLINSKI",
        "first_name": "RALPH",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "000046005",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME 46005",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME 46005",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "FL",
            "license": "NE 46005",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "64543",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098653400",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00827133",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.