Jeffrey R Zack, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

213570 Issued in MA

Practice address

1 Hospital Rd.
Martha'a Vineyard Hospital
Oak Bluffs, MA 02557

Phone

(508) 693-0410

NPI assigned

Jul 21, 2006

Last updated

Nov 25, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zack.jeffrey.mvh@direct.partners.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Martha's Vineyard Hospital, Inc.

  • Internal Medicine Physician
  • Oak Bluffs, MA
  • NPI 1194866210

  Emergency Medicine

  Medicare reassignment NPD
• Lifeguard Medical Group, LLC

  • Emergency Medicine Physician
  • Chilmark, MA
  • NPI 1548436538
  NPD Authorized official
• Martha's Vineyard Hospital

  dba Martha's Vineyard Hospital Physician Group

  • Obstetrics & Gynecology Physician
  • Oak Bluffs, MA
  • NPI 1962465500
  NPD
• Martha's Vineyard Hospital, Inc.

  • Critical Access Hospital
  • Oak Bluffs, MA
  • NPI 1134206386
  NPD
• Brown Emergency Medicine

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1962455022
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1578584314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1477",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "025571477",
            "telephone_number": "508-957-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL RD.",
            "address_2": "MARTHA'A VINEYARD HOSPITAL",
            "city": "OAK BLUFFS",
            "state": "MA",
            "postal_code": "02557",
            "telephone_number": "508-693-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACK",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD10339",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "213570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7008366",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICAL LICENSE",
            "identifier": "MD10339",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE",
            "identifier": "007008366",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578584314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Wise
• WNR Inc
• Timothy G Wolff
• Eileen Wuerthele, C.P.N.P., P.C.
• Gerald Yukevich, M.D.
• Linda Carmen Zarro, SLP
• Amanda Zoref, LICSW

• Emergency Medicine Physician in Oak Bluffs, MA
• Providers in Oak Bluffs, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.