NPIMap

Individual provider Active NPI

John P Dzik, DO

  • Family Medicine Physician
  • Amarillo, TX
National Provider Identifier
1659339950
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H7011 Issued in TX
Practice address
5211 SW 9TH Ave
Amarillo, TX 79106-4120
Phone
(806) 356-0026
NPI assigned
May 3, 2006
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H7011 TX Primary

Addresses

Primary practice location

5211 SW 9TH Ave
Amarillo, TX 79106-4120

Mailing address

PO Box 7391
Amarillo, TX 79114-7391
Phone (806) 622-2725

Other identifiers 1

IdentifierTypeStateIssuer
139897623MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816001248 TX Practitioner - Family Practice 2668445131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FMC LTC Aco LLCGroup PAC ID 3678013729, 22 clinicians
FMC Long-Term Care PAGroup PAC ID 7416380423, 23 clinicians

Practice addresses (Care Compare)

2501 Lakeview Dr
Amarillo, TX 79109-1531
Phone (806) 350-8277

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
FMC Long-Term Care, P.a. Family Medicine CurrentSince Dec 30, 2019 Accepting new patients
FMC LTC Aco LLC Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Stratford Hospital District Past Accepting new patients
Childress County Hospital District Past Accepting new patients
Stratford Hospital District Past Accepting new patients
Panhandle Emergency Physicians, P.a. Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
Texas Tech University Health Sciences Center University Associates Family Medicine Past Accepting new patients
Amarillo VI Enterprises, LLC Past Accepting new patients
High Plains Medical Group, LLC Past Accepting new patients

Locations

1616 S Kentucky St
Ste B100
Amarillo, TX 79102
Phone (806) 355-8900

2501 Lakeview Dr
Amarillo, TX 79109
Phone (806) 350-7325

5211 W 9th Ave
Amarillo, TX 79106
Phone (806) 350-8277

Interoperability endpoints

  • Direct secure messaging: john.dzik@ipmcentral.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kirkland Court Health and Rehabilitation CenterAmarillo, TX, CCN 675336 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 15, 2022
Jul 15, 2022
Amarillo Center for Skilled CareAmarillo, TX, CCN 676347 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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 11

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1659339950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7391",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791147391",
            "telephone_number": "806-622-2725",
            "fax_number": "806-352-4887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5211 SW 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064120",
            "telephone_number": "806-356-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIK",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H7011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139897623",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.