Individual provider Active NPI

Mary Elizabeth Zimmermann, ACNS-BC

  • Adult Health Clinical Nurse Specialist
  • Fort Worth, TX
National Provider Identifier
1639337546
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
662977 Issued in TX
Practice address
1319 Summit Ave Ste 200
Fort Worth, TX 76102-4432
Phone
(817) 336-0551
NPI assigned
May 28, 2008
Last updated
Sep 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 662977 TX Primary

Addresses

Primary practice location

1319 Summit Ave Ste 200
Fort Worth, TX 76102-4432

Mailing address

1319 Summit Ave Ste 200
Fort Worth, TX 76102-4432
Phone (817) 336-0551

Other identifiers 1

IdentifierTypeStateIssuer
2006003835-05OtherTXANCC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080813000047 TX Practitioner - Certified Clinical Nurse Specialist (CNS) 1850466723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Surgery Associates PAGroup PAC ID 0042122137, 58 clinicians
North Texas Critical Care PAGroup PAC ID 6103041637, 79 clinicians

Practice addresses (Care Compare)

1400 8TH Ave
Fort Worth, TX 76104-4110
Phone (214) 821-1599

2710 Swiss Ave
Dallas, TX 75204-5900
Phone (214) 821-2303

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.41 of 100Reported as group
Quality
88.72
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
662977TXMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Critical Care PA CurrentSince May 1, 2020 Accepting new patients
Urgent Surgery Associates, P.a. CurrentSince Jan 8, 2022 Accepting new patients
Center for Neurological Disorders, PA PastSince Feb 22, 2010 Accepting new patients

Locations

2710 Swiss Ave
Dallas, TX 75204
Phone (214) 821-2303

3500 Gaston Ave
Dallas, TX 75246

621 N Hall St
Dallas, TX 75226
Phone (214) 820-0600

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1639337546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 SUMMIT AVE STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024432",
            "telephone_number": "817-336-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1319 SUMMIT AVE STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024432",
            "telephone_number": "817-336-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "ACNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "662977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2006003835-05",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.