Stanislav Zinkovsky, OTR, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005165 Issued in MI

Practice address

22972 Lahser Rd
Southfield, MI 48033-4408

Phone

(248) 353-0079

NPI assigned

Mar 9, 2007

Last updated

Oct 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment NPD
• Home Physicians Team PLLC

  • Family Medicine Physician
  • Birmingham, MI
  • NPI 1699590075
  Medicare reassignment
• Michigan Rehabilitation Physicians

  • Physical Medicine & Rehabilitation Physician
  • Detroit, MI
  • NPI 1215240502
  Medicare reassignment
• Jawad a Shah MD PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
  • NPI 1114667763
  NPD
• Embrace Home Physicians PLLC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1548704778
  NPD (past)
• Higher Standard Therapeutics Rehab PC

  • General Practice Physician
  • Detroit, MI
  • NPI 1417264573
  NPD (past)
• Maecenas Health Systems PC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1003155607
  NPD (past)
• Mobilized Docs of Michigan LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Farmington Hills, MI
  • NPI 1699055269
  NPD (past)
• Rhett Enterprises, Inc.

  dba Magna Care Home Health Services

  • Multi-Specialty Clinic/Center
  • Southfield, MI
  • NPI 1407284219
  NPD (past)
• Vitality Group Inc

  dba Vitality Health Services inc

  • Home Health Agency
  • Southfield, MI
  • NPI 1316194210
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1689706525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 LANGLEWOOD DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222021",
            "telephone_number": "248-819-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22972 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334408",
            "telephone_number": "248-353-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZINKOVSKY",
        "first_name": "STANISLAV",
        "credential": "OTR, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005165",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "520106097",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "670H202270",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trevor Zielinski
• Candace Ziglor, B.A., B.S.W., M.S.W.
• Jessica Zimmer
• Desiree Bernadette Zinevich, LLMSW
• Jacob Alan Zinke, CCC-SLP
• Zoe Counseling Services
• Michael Zoerman
• Hashem H Zokary, MD
• Dunia Zoma
• Meghan M Zorza, CRNA

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.