Individual provider Active NPI

Stacy Nicole Zolp, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1699902601
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005534 Issued in MI
Practice address
1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone
(269) 226-7000
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005534 MI Primary

Addresses

Primary practice location

1521 Gull Rd
Kalamazoo, MI 49048-1640

Mailing address

5370 Four Seasons Dr
Kalamazoo, MI 49009-8964
Phone (586) 942-4520

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090831000418 MI Practitioner - Physician Assistant 0648325449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1701 Gull Rd
Kalamazoo, MI 49048-1609
Phone (269) 633-2510

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601005534MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Hospital CurrentSince Nov 19, 2015 Accepting new patients
Ascension Medical Group Promed CurrentSince Jul 15, 2013 Accepting new patients
Promed Healthcare CurrentSince Jul 15, 2013 Accepting new patients
Ascension Borgess Hospital CurrentSince Nov 19, 2015 Accepting new patients
Ascension Medical Group Promed Past Accepting new patients
Kalamazoo Emergency Associates, PLC Past Accepting new patients

Locations

551 Linn St
Allegan, MI 49010
Phone (269) 686-5800

3035 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 565-9100

1701 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-2550

1535 Gull Rd
Ste 15
Kalamazoo, MI 49048
Phone (269) 226-6933

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1699902601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5370 FOUR SEASONS DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098964",
            "telephone_number": "586-942-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLP",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.