Theodore Daniel Zaki, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

68724 Issued in AZ

Practice address

13995 W Statler Blvd Ste 150
Surprise, AZ 85374-5512

Phone

(480) 556-0446

NPI assigned

Mar 19, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Dermatology

Education

Yale University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard Lee Averitte Jr PLLCGroup PAC ID 9638069099, 31 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tzaki@affderm.emadirect.md

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.

• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1407804115
  Medicare reassignment Care Compare group NPD
• Richard Lee Averitte Jr PLLC

  dba Affiliated Dermatology

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1609291848
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Surprise, AZ
  • NPI 1598112831
  NPD (past)
• Richard Lee Averitte Jr., PLLC

  dba Affiliated Dermatology

  • Non-Pharmacy Dispensing Site
  • Anthem, AZ
  • NPI 1619428851
  NPD (past)

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1528527561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 150",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745512",
            "telephone_number": "480-556-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 150",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745512",
            "telephone_number": "480-556-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKI",
        "first_name": "THEODORE",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "68724",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "68724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nerissa Apostol Zafe, NP-C
• Emma Rose Zahner
• Syed Hassan Abbas Zaidi
• Nash Zaitoon
• Marina Lisa Zakala, M.D.
• Marie Zannini, LPN
• Helio Carmelo Zapata, M.D.
• Anna Zaremba, DPT
• Shima Zargar, MD
• Zastrow Chiropractic Clinic Inc

• Dermatology Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.