Individual provider Active NPI

Kenneth T. Zylstra, PA

  • Physician Assistant
  • Greenacres, FL
National Provider Identifier
1528239662
Registry record updated Mar 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104399 Issued in FL
Practice address
5799 Lake Worth Rd
Greenacres, FL 33463-3207
Phone
(305) 500-2000
NPI assigned
Mar 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104399 FL Primary

Addresses

Primary practice location

5799 Lake Worth Rd
Greenacres, FL 33463-3207

Mailing address

5799 Lake Worth Rd
Greenacres, FL 33463-3207
Phone (305) 500-2000

Other identifiers 1

IdentifierTypeStateIssuer
PA9104399OtherFLPA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kenneth.zylstra.1@29601.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20080618000686 FL Practitioner - Physician Assistant 5294806279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

5799 Lake Worth Rd
Greenacres, FL 33463-3207
Phone (561) 967-0234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

Hospital & facility affiliations 2

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773532800000",
    "number": "1528239662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5799 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633207",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5799 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633207",
            "telephone_number": "305-500-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYLSTRA",
        "first_name": "KENNETH",
        "middle_name": "T.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-17",
        "last_updated": "2026-03-15",
        "certification_date": "2026-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA9104399",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenneth.zylstra.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "5799 Lake Worth Rd",
            "city": "Greenacres",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334633207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.