Active NPI
Douglas Zischkau, MD
- Family Medicine Physician
- Santa Teresa, NM
National Provider Identifier
1558325969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 92381
- Practice address
- 5055 McNutt Rd
Santa Teresa, NM 88008-9442 - Phone
- (575) 589-5005
- Fax
- (575) 589-1333
- NPI assigned
- Apr 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 92381 | NM | Primary |
Addresses
Primary practice location
5055 McNutt Rd
Santa Teresa, NM 88008-9442
Mailing address
5055 McNutt Rd
Santa Teresa, NM 88008-9442
Phone (575) 589-5005
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 396826ZS5H | Other | NM | WELLMED PTAN |
| 14645 | Medicaid | NM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 92381 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deming Hospital Corporation | Past | Accepting new patients |
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.
-
- Pain Medicine (Anesthesiology) Physician
- Deming, NM
- NPI 1386850519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465948800000",
"number": "1558325969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5055 MCNUTT RD",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "880089442",
"telephone_number": "575-589-5005",
"fax_number": "575-589-1333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5055 MCNUTT RD",
"city": "SANTA TERESA",
"state": "NM",
"postal_code": "880089442",
"telephone_number": "575-589-5005",
"fax_number": "575-589-1333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZISCHKAU",
"first_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2016-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "92381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMED PTAN",
"identifier": "396826ZS5H",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "14645",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Teresa, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.