Individual provider Active NPI

Mark D Zimmerman, DO

  • Pain Medicine (Anesthesiology) Physician
  • Vero Beach, FL
National Provider Identifier
1689623746
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
OS0007702 Issued in FL
Practice address
3745 11TH Circle
Suite 107
Vero Beach, FL 32960
Phone
(772) 778-2444
Fax
(772) 778-8299
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X OS0007702 FL Primary

Addresses

Primary practice location

3745 11TH Circle
Suite 107
Vero Beach, FL 32960

Mailing address

3745 11TH Circle
Suite 107
Vero Beach, FL 32960
Phone (772) 778-2444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS0007702FLMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Management of the Treasure Coast PA Pain Medicine PastSince Nov 10, 2005 Accepting new patients
Jima L Jones Et Al PTR Past Accepting new patients
Healthstar Spinal Center Inc Past Accepting new patients
Anesthesia of Indian River Inc Pain Medicine Past Accepting new patients

Organizations & group practices 4

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1689623746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 11TH CIRCLE",
            "address_2": "SUITE 107",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "telephone_number": "772-778-2444",
            "fax_number": "772-778-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 11TH CIRCLE",
            "address_2": "SUITE 107",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "telephone_number": "772-778-2444",
            "fax_number": "772-778-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "OS0007702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.