Individual provider Active NPI

Mark A Zitnik, DC

  • Rehabilitation Chiropractor
  • Mesa, AZ
National Provider Identifier
1598836264
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
7770 Issued in AZ
Practice address
5233 E Southern Ave
Suite 104
Mesa, AZ 85206-3625
Phone
(480) 830-2882
Fax
(480) 830-2881
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 7770 AZ Primary

Addresses

Primary practice location

5233 E Southern Ave
Suite 104
Mesa, AZ 85206-3625

Mailing address

5233 E Southern Ave
Ste 104
Mesa, AZ 85206-3628
Phone (480) 830-2882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000691 AZ Practitioner - Chiropractic 7113018987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Southern Medical Group LLCGroup PAC ID 0547503542, 3 clinicians

Practice addresses (Care Compare)

5233 E Southern Ave
Suite 103
Mesa, AZ 85206-3628
Phone (480) 830-2882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7770AZMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Southern Medical Group, LLC CurrentSince May 1, 2019 Accepting new patients
Arizona Vascular Professionals, LLC PastSince Oct 10, 2023 Accepting new patients
Mesa Chiropractic Corp Rehabilitation Past Accepting new patients
Back to Back Chiropractic, Inc Chiropractor PastSince Apr 7, 2017 Accepting new patients
Mark a Zitnik DC, LLC Chiropractor PastSince Jan 1, 1990 Accepting new patients

Locations

5233 E Southern Ave
Ste 103
Mesa, AZ 85206
Phone (480) 830-2882

5233 E Southern Ave
Ste 104
Mesa, AZ 85206
Phone (480) 567-5267

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1598836264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5233 E SOUTHERN AVE",
            "address_2": "STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063628",
            "telephone_number": "480-830-2882",
            "fax_number": "480-830-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 E SOUTHERN AVE",
            "address_2": "SUITE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063625",
            "telephone_number": "480-830-2882",
            "fax_number": "480-830-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITNIK",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "7770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.