Individual provider Active NPI

Donald James Zoltan, MD

  • Orthopaedic Surgery Physician
  • Greenfield, WI
National Provider Identifier
1588653315
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
24780 Issued in WI
Practice address
3033 W Layton Ave
Greenfield, WI 53221-2628
Phone
(414) 647-0033
Fax
(414) 647-0079
NPI assigned
Oct 14, 2005
Last updated
Aug 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 24780 WI Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 24780 WI

Addresses

Primary practice location

3033 W Layton Ave
Greenfield, WI 53221-2628

Mailing address

3033 W Layton Ave
Greenfield, WI 53221-2628
Phone (414) 647-0033

Other identifiers 1

IdentifierTypeStateIssuer
30819200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20100706000479 WI Practitioner - Orthopedic Surgery 7911952486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24780WIMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Polacheck MD SC PastSince Jan 13, 2006 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1588653315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-647-0033",
            "fax_number": "414-647-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-647-0033",
            "fax_number": "414-647-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLTAN",
        "first_name": "DONALD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "24780",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WI",
            "license": "24780",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30819200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.