Individual provider Active NPI

Zachary Mellerowicz, PA-C

  • Physician Assistant
  • Rochester Hills, MI
National Provider Identifier
1639697980
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012063 Issued in MI
Practice address
2940 Crooks Rd
Rochester Hills, MI 48309-3609
Phone
(248) 997-9700
NPI assigned
Sep 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5601012063 MI
Physician Assistant 363A00000X 5601012063 MI Primary

Addresses

Primary practice location

2940 Crooks Rd
Rochester Hills, MI 48309-3609

Mailing address

2940 Crooks Rd
Rochester Hills, MI 48309-3609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240123004543 MI Practitioner - Physician Assistant 9931551199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stonebrooke Family PhysiciansGroup PAC ID 7315992922, 9 clinicians

Practice addresses (Care Compare)

2940 Crooks Rd
Rochester Hills, MI 48309-3609
Phone (248) 934-1703

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012063MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stonebrooke Family Physicians Family Medicine CurrentSince Jan 15, 2024 Accepting new patients

Locations

2940 Crooks Rd
Rochester Hills, MI 48309
Phone (248) 934-1703

Interoperability endpoints

  • Direct secure messaging: zmellerowicz808796@direct.hfhs.org
  • Direct secure messaging: zacharymellerowicz@sfp.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1639697980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 CROOKS RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 CROOKS RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093609",
            "telephone_number": "248-997-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLEROWICZ",
        "first_name": "ZACHARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5601012063",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.