Phillip Zalog, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

815-023 Issued in WI

Practice address

W190N5053 Sunset View Dr
Menomonee Falls, WI 53051-6436

Phone

(262) 783-6265

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)
• Great Lakes Radiologists SC

  • Diagnostic Radiology Physician
  • New Berlin, WI
  • NPI 1609800291
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548255508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W190N5053 SUNSET VIEW DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530516436",
            "telephone_number": "262-783-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W190N5053 SUNSET VIEW DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530516436",
            "telephone_number": "262-783-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALOG",
        "first_name": "PHILLIP",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "815-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42960800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aisha Yousuf, M.D
• Terry Marie Zacharias, FNP-BC, APNP
• Mehwish A Zaidi, PA-C
• Vaishali Zala, RD
• Eric Zall, DDS
• Kevin M Zeeck, M.D.
• Marie T Zeidler, PAC
• Kristin Michelle Zelinsky, RN
• Sara Zemanovic, CAA
• Richard J Ziegler, R.PH.

• Physician Assistant in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.