Organization Active NPI

Zaurov Psychiatry, PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Keizer, OR
National Provider Identifier
1528505401
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201700161NP-PP Issued in OR
Legal business name
ZAUROV PSYCHIATRY, PC
Practice address
3787 River Rd North
Suite a
Keizer, OR 97303
Phone
(971) 599-3411
Fax
(971) 999-0906
NPI assigned
Jan 30, 2017
Last updated
Feb 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Michael Zaurov, PMHNPNPI 1821547886
Title
Owner
Phone
(971) 599-3411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 201700160RN OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201700161NP-PP OR Primary
Community/Behavioral Health Agency 251S00000X 201700161NP-PP OR

Addresses

Primary practice location

3787 River Rd North
Suite a
Keizer, OR 97303

Mailing address

3787 River Rd North
Suite a
Keizer, OR 97303
Phone (971) 599-3411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190418000939 OR Part B Supplier - Clinic/Group Practice 1254672314 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, OR

National Provider Directory

National Provider Directory

Locations

3787 River Rd N
Ste A
Keizer, OR 97303
Phone (503) 763-1778

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1528505401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3787 RIVER RD NORTH",
            "address_2": "SUITE A",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "97303",
            "telephone_number": "971-599-3411",
            "fax_number": "971-999-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3787 RIVER RD NORTH",
            "address_2": "SUITE A",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "97303",
            "telephone_number": "971-599-3411",
            "fax_number": "971-999-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZAUROV PSYCHIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "ZAUROV",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-599-3411",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201700160RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201700161NP-PP",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "201700161NP-PP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.