Individual provider Active NPI

Gerald Bruce Zelenock, M.D.

  • Surgery Physician
  • Toledo, OH
National Provider Identifier
1639214034
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35089295 Issued in OH
Practice address
3000 Arlington Ave
Toledo, OH 43614-2595
Phone
(419) 383-3759
Fax
(419) 383-3057
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35089295 OH Primary
Vascular Surgery Physician 2086S0129X 35089295 OH

Addresses

Primary practice location

3000 Arlington Ave
Toledo, OH 43614-2595

Mailing address

3355 Glendale Ave
3Rd Floor
Toledo, OH 43614-2426
Phone (419) 383-7146

Other identifiers 1

IdentifierTypeStateIssuer
0694155MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35089295OHMDVascular Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1639214034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 GLENDALE AVE",
            "address_2": "3RD FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142426",
            "telephone_number": "419-383-7146",
            "fax_number": "419-383-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-383-3759",
            "fax_number": "419-383-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELENOCK",
        "first_name": "GERALD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35089295",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35089295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0694155",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.