Individual provider Active NPI

Zachary Calnan Fridirici

  • Facial Plastic Surgery Physician
  • San Francisco, CA
National Provider Identifier
1710229893
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
156538 Issued in CA
Practice address
2233 Post St FL 3
San Francisco, CA 94115
Phone
(415) 476-4952
Fax
(415) 885-7546
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YS0123X 156538 CA Primary

Addresses

Primary practice location

2233 Post St FL 3
San Francisco, CA 94115

Mailing address

2233 Post St FL 3
San Francisco, CA 94115-3470
Phone (415) 476-4952

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-1676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180802002298 CA Practitioner - Otolaryngology 0446552632 Reassigns benefits to 1 organization
I20200219001160 WI Practitioner - Otolaryngology 0446552632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loyola University of Chicago, Stritch School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moreland Ear Nose and Throat Group LTDGroup PAC ID 4284605494, 13 clinicians

Practice addresses (Care Compare)

1111 Delafield St
Suite 102
Waukesha, WI 53188-3402
Phone (262) 547-1614

Hospital & facility affiliations

  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
156538CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California SFGH Medical Group Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Moreland Ear Nose & Throat Group LTD Single Specialty CurrentSince Dec 23, 2019 Accepting new patients
University of California SFGH Medical Group Single Specialty Current Accepting new patients
University of California SFGH Medical Group Single Specialty CurrentSince Jul 1, 2018 Accepting new patients

Locations

1001 Potrero Ave
Rm 3A32
San Francisco, CA 94110
Phone (628) 206-8291

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

13900 W National Ave
Ste 100
New Berlin, WI 53151
Phone (262) 928-4500

1111 Delafield St
Ste 102
Waukesha, WI 53188
Phone (262) 547-1614

1111 Delafield St
Ste 100
Waukesha, WI 53188
Phone (262) 928-4300

Interoperability endpoints

  • Direct secure messaging: zfridirici120414@direct.phci.org

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.

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1710229893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 POST ST FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153470",
            "telephone_number": "415-476-4952",
            "fax_number": "415-885-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 POST ST FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-476-4952",
            "fax_number": "415-885-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-1676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIDIRICI",
        "first_name": "ZACHARY",
        "middle_name": "CALNAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "156538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.