Individual provider Active NPI

Zachary Martin Shnek, PH.D.

  • Psychologist
  • Tucson, AZ
National Provider Identifier
1679809214
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4053 Issued in AZ
Practice address
7360 N la Cholla Blvd
Tucson, AZ 85741-2305
Phone
(520) 306-6028
Fax
(520) 579-0798
NPI assigned
Nov 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4053 AZ
Psychologist 103T00000X 4053 AZ Primary

Addresses

Primary practice location

7360 N la Cholla Blvd
Tucson, AZ 85741-2305

Mailing address

13198 N Pier Mountain Rd
Marana, AZ 85658-4228
Phone (520) 306-6028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100419000332 AZ Practitioner - Clinical Psychologist 5395872600 Practice locations: Marana, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13198 N Pier Mountain Rd
Marana, AZ 85658-4228
Phone (520) 306-6028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4053AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1679809214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13198 N PIER MOUNTAIN RD",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856584228",
            "telephone_number": "520-306-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7360 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412305",
            "telephone_number": "520-306-6028",
            "fax_number": "520-579-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHNEK",
        "first_name": "ZACHARY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-02",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4053",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "4053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.