Active NPI
Michael Zlomke, M.D.
- Surgery Physician
- Council Bluffs, IA
National Provider Identifier
1700878220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 26066
- Practice address
- 201 Ridge St
Suite 214
Council Bluffs, IA 51503-4643 - Phone
- (712) 396-4320
- Fax
- (712) 396-4328
- NPI assigned
- Aug 19, 2005
- Last updated
- May 1, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 26066 | IA | Primary |
Addresses
Primary practice location
201 Ridge St
Suite 214
Council Bluffs, IA 51503-4643
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-5451
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508858028 | Medicaid | NE | |
| 17008782200 | Medicaid | IA | |
| 1250050 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26066 | IA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493596800000",
"number": "1700878220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3755",
"city": "OMAHA",
"state": "NE",
"postal_code": "681030755",
"telephone_number": "402-354-5451",
"fax_number": "402-354-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 RIDGE ST",
"address_2": "SUITE 214",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034643",
"telephone_number": "712-396-4320",
"fax_number": "712-396-4328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZLOMKE",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-19",
"last_updated": "2017-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IA",
"license": "26066",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508858028",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "17008782200",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1250050",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.