Individual provider Active NPI

Deanna Jean Cichon Zimkus, PA-C

  • Physician Assistant
  • Wolcott, CT
National Provider Identifier
1710211370
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2301 Issued in CT
Practice address
464 Wolcott Rd Ste 3
Wolcott, CT 06716-2626
Phone
(203) 879-6171
Fax
(203) 879-1191
NPI assigned
Sep 29, 2009
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 2301 CT Primary

Addresses

Primary practice location

464 Wolcott Rd Ste 3
Wolcott, CT 06716-2626

Mailing address

4700 Exchange CT Ste 110
Advanced Dermatology Center, PC
Boca Raton, FL 33431-4450
Phone (561) 948-0291

Other names 1

  • Ms. Deanna Jean Cichon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100212000583 CT Practitioner - Physician Assistant 9335283472 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
Advanced Dermatology Center, PCGroup PAC ID 5294623005, 4 clinicians

Practice addresses (Care Compare)

464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-6171

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Waterbury, LLC CurrentSince Mar 1, 2026 Accepting new patients
Integrated Dermatology of Wolcott PLLC PastSince Mar 1, 2026 Accepting new patients
CT Emergency Medicine Specialists, LLC Past Accepting new patients

Locations

464 Wolcott Rd
Ste 3
Wolcott, CT 06716
Phone (203) 879-6171

4700 Exchange Ct
Ste 110
Boca Raton, FL 33431
Phone (561) 223-8081

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1710211370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "address_2": "ADVANCED DERMATOLOGY CENTER, PC",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 WOLCOTT RD STE 3",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162626",
            "telephone_number": "203-879-6171",
            "fax_number": "203-879-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMKUS",
        "first_name": "DEANNA",
        "middle_name": "JEAN CICHON",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "2301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "CICHON",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wolcott, CT

Sources for this page

Verify at the official NPI Registry.