Individual provider Active NPI

Domenic A Zambuto, MD

  • Vascular & Interventional Radiology Physician
  • Tampa, FL
National Provider Identifier
1669458766
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
ME158436 Issued in FL
Practice address
3810 Northdale Blvd Ste 150
Tampa, FL 33624-1871
Phone
(813) 683-4784
Fax
(888) 812-8191
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2025

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology Physician 202K00000X ME158436 FL
Vascular & Interventional Radiology Physician 2085R0204X U1791 TX
Vascular & Interventional Radiology Physician 2085R0204X 67934 AZ
Vascular & Interventional Radiology Physician 2085R0204X 036.126576 IL
Vascular & Interventional Radiology Physician 2085R0204X 323885 NY
Vascular & Interventional Radiology Physician 2085R0204X DR.0069421 CO
Vascular & Interventional Radiology Physician 2085R0204X 77011 GA
Vascular & Interventional Radiology Physician 2085R0204X 25MA09461600 NJ
Vascular & Interventional Radiology Physician 2085R0204X ME158436 FL Primary

Addresses

Primary practice location

3810 Northdale Blvd Ste 150
Tampa, FL 33624-1871

Mailing address

3820 Northdale Blvd Ste 201
Tampa, FL 33624-1893
Phone (800) 991-6117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, FL, GA, AZ, TX6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20230804001242 NJ Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8628972445 Reassigns benefits to 1 organization
I20230810002829 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8628972445 Reassigns benefits to 1 organization
I20231102003765 FL Practitioner - Interventional Radiology 8628972445 Reassigns benefits to 1 organization
I20231103001532 GA Practitioner - Interventional RadiologyPractitioner - Diagnostic RadiologyPractitioner - Other (Physician) 8628972445 Reassigns benefits to 1 organization
I20231205001662 AZ Practitioner - Interventional Radiology 8628972445 Reassigns benefits to 1 organization
I20240517003607 TX Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8628972445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Harvard Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wazni PLLCGroup PAC ID 2860629466, 30 clinicians
Georgia Uvc Medical LLCGroup PAC ID 4284081811, 9 clinicians

Practice addresses (Care Compare)

3657 Madaca LN
Tampa, FL 33618-2048
Phone (800) 991-6117

371 E Paces Ferry Rd NE
Suite 630
Atlanta, GA 30305-2372
Phone (800) 991-6117

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME158436FLMDPhlebology Physician
DR.0069421COMDVascular & Interventional Radiology Physician
036.126576ILMDVascular & Interventional Radiology Physician
323885NYMDVascular & Interventional Radiology Physician
U1791TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wazni, PLLC CurrentSince Dec 1, 2023 Accepting new patients
Arizona Uvc Medical PLLC CurrentSince Dec 1, 2023 Accepting new patients
Texas Uvc Medical PLLC Vascular & Interventional Radiology CurrentSince Sep 20, 2023 Accepting new patients
Georgia Uvc Medical LLC Phlebology CurrentSince Oct 25, 2023 Accepting new patients
Wilton Vascular Medical Group PC PastSince Sep 25, 2019 Accepting new patients
Pennsylvania Phlebology Group PC Phlebology PastSince Sep 20, 2017 Accepting new patients
Valley Physician Services PC Past Accepting new patients
Tolland Imaging Center, LLC Past Accepting new patients
Colorado Medical Group, PLLC Family Medicine Past Accepting new patients

Locations (25 of 27)

655 S Dobson Rd
Ste 216
Chandler, AZ 85224
Phone (480) 899-5530

13555 W McDowell Rd
Ste 210
Goodyear, AZ 85395
Phone (602) 406-0630

1010 E McDowell Rd
Ste 103
Phoenix, AZ 85006
Phone (602) 254-4424

1900 Glades Rd
Ste 100
Boca Raton, FL 33431
Phone (561) 416-1145

18167 US Highway 19 N
Ste 100
Clearwater, FL 33764
Phone (727) 233-4177

2290 10th Ave N
Ste 101
Lake Worth, FL 33461
Phone (561) 450-2703

3003 S Florida Ave
Ste 101
Lakeland, FL 33803
Phone (863) 687-8990

4619 Little Rd
New Pt Richey, FL 34655
Phone (727) 372-9918

4215 Burns Rd
Ste 260
Palm Beach Gardens, FL 33410

295 NW Peacock Blvd
Port St Lucie, FL 34986

3810 Northdale Blvd
Ste 260
Tampa, FL 33624

3657 Madaca Ln
Tampa, FL 33618

3820 Northdale Blvd
Ste 201
Tampa, FL 33624

3810 Northdale Blvd
Ste 150
Tampa, FL 33624
Phone (813) 683-4784

3609 Madaca Ln
Tampa, FL 33618
Phone (720) 253-3071

8029 Cooper Creek Blvd
Ste 104
University Park, FL 34201

16553 S US Highway 301
Wimauma, FL 33598

371 E Paces Ferry Rd NE
Ste 630
Atlanta, GA 30305

3805 Crestwood Pkwy NW
Ste 350
Duluth, GA 30096

3525 Busbee Dr NW
Ste 101
Kennesaw, GA 30144

635 Madison Ave
Fl 1400
New York, NY 10022
Phone (212) 634-4233

635 Medical Pkwy
Brenham, TX 77833
Phone (979) 830-1444

5801 Oakbend Trl
Fort Worth, TX 76132
Phone (817) 361-1420

5801 Oakbend Trl
Ste 180
Ft Worth, TX 76132
Phone (817) 370-9010

1631 Lancaster Dr
Ste 200
Grapevine, TX 76051
Phone (817) 329-5433

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1669458766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTHDALE BLVD STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241893",
            "telephone_number": "800-991-6117",
            "fax_number": "888-812-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 NORTHDALE BLVD STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241871",
            "telephone_number": "813-683-4784",
            "fax_number": "888-812-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMBUTO",
        "first_name": "DOMENIC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME158436",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "U1791",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AZ",
            "license": "67934",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036.126576",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "323885",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "DR.0069421",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "77011",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA09461600",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME158436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.