NPIMap

Individual provider Active NPI

Mary Ann Zakutney, MD, PH.D.

  • Family Medicine Physician
  • Irwin, PA
National Provider Identifier
1720055049
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD447210 Issued in PA
Practice address
3520 Route 130
BLD 2 Suite 2002
Irwin, PA 15642-1438
Phone
(724) 744-6167
Fax
(724) 744-6070
NPI assigned
Mar 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PERMIT 76290 AZ
Family Medicine Physician 207Q00000X 39285 IA
Family Medicine Physician 207Q00000X MD447210 PA Primary

Addresses

Primary practice location

3520 Route 130
BLD 2 Suite 2002
Irwin, PA 15642-1438

Mailing address

520 Jefferson Ave
Suite 400
Jeannette, PA 15644-2538
Phone (724) 527-8060

Other identifiers 1

IdentifierTypeStateIssuer
1023735980002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130219000212 PA Practitioner - Family Practice 1153473251 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PERMIT 76290AZMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Excela Health Physician Practices, Inc. Family Medicine CurrentSince Jan 2, 2013 Accepting new patients
Centerville Clinics, Inc CurrentSince Jun 5, 2020 Accepting new patients
Centerville Clinics, Inc. Family Medicine CurrentSince Jun 5, 2020 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Jan 2, 2013 Accepting new patients

Locations

1070 Old National Pike
Fredericktown, PA 15333

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

3520 Route 130
Ste 2002
Irwin, PA 15642
Phone (724) 744-6167

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1720055049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 JEFFERSON AVE",
            "address_2": "SUITE 400",
            "city": "JEANNETTE",
            "state": "PA",
            "postal_code": "156442538",
            "telephone_number": "724-527-8060",
            "fax_number": "724-522-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 ROUTE 130",
            "address_2": "BLD 2 SUITE 2002",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156421438",
            "telephone_number": "724-744-6167",
            "fax_number": "724-744-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKUTNEY",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "MD, PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-06",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "PERMIT 76290",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "39285",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD447210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023735980002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irwin, PA

Sources for this page

Verify at the official NPI Registry.