Carissa Zackus, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP034284 Issued in PA

Practice address

335 S Franklin St
335 S Franklin St
Wilkes Barre, PA 18702-3808

Phone

(570) 301-0924

Fax

(570) 505-6224

NPI assigned

Oct 17, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Children's Service Center of Wyoming Valley, Inc

  • Counselor
  • Wilkes Barre, PA
  • NPI 1700861242
  Medicare reassignment NPD
• Children's Service Center of Wyoming Valley, Inc

  • Occupational Therapist
  • Wilkes Barre, PA
  • NPI 1649060955
  NPD
• Children's Service Center of Wyoming Valley, Inc

  • Federally Qualified Health Center (FQHC)
  • Wilkes Barre, PA
  • NPI 1710617857
  NPD

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1578430302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 S FRANKLIN ST",
            "address_2": "335 S FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023808",
            "telephone_number": "570-825-6425",
            "fax_number": "570-762-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 S FRANKLIN ST",
            "address_2": "335 S FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023808",
            "telephone_number": "570-301-0924",
            "fax_number": "570-505-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACKUS",
        "first_name": "CARISSA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP034284",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN706919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyungeun Yun
• Z & L Holdings Corporation (Building Blocks Learning Center)
• Charlene Kosior Zablotney, MSN CRNP
• Anne M Zaborny, SLP
• Anita Louise Zaboski, LSW
• Mohammad Munim Zahoor
• Akram A Zalatimo, M.D.
• Lori L Zaleski, R.PH.
• Syed Zaman, M.D
• Melissa A. Zambetti, PA-C

• Family Nurse Practitioner in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.