Kirellos Zamary, M.D.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

A124822 Issued in CA

Practice address

1165 Montgomery Dr
Santa Rosa, CA 95405-4801

Phone

(707) 547-4608

Fax

(707) 547-4609

NPI assigned

Jun 7, 2011

Last updated

Nov 11, 2021By 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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

University of California, Irvine, California College of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oc Trauma IncGroup PAC ID 7214205152, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kzamary1658487@oc.providencedirect.org

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.

• Oc Trauma Inc

  • Trauma Surgery Physician
  • Mission Viejo, CA
  • NPI 1720516628
  Medicare reassignment Care Compare group NPD
• Agape Dermatology PC

  dba Z Dermatology & Skin Wellness Center

  • Dermatology Physician
  • Huntington Beach, CA
  • NPI 1073152112

  Surgery

  Medicare reassignment NPD
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  dba Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1619261609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "707-547-4608",
            "fax_number": "707-547-4609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5180",
            "fax_number": "401-444-6681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMARY",
        "first_name": "KIRELLOS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "LP02339",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A124822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kzamary1658487@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1162 Montgomery Dr Fl 3",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kzamary1658487@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "121 Sotoyome St Ste 201",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brandon Zagami
• Konstantin G. Zaharoff Jr., MD
• Sam Zakkour, PHARM.D.
• Michael Zakovich, DO
• Kenny Zaldana, DPT
• Maira Zamora Mendoza
• Maria Zamora Mendoza
• Perla Esmeralda Zamora
• Vanessa Zamora
• Jeannie Zanetti

• Surgical Critical Care Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Surgical Critical Care Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.