NPIMap

Individual provider Active NPI

Charles J Zeller IV, D.O.

  • Otolaryngology Physician
  • Deerfield Beach, FL
National Provider Identifier
1720086366
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
OS14031 Issued in FL
Practice address
1801 W Sample Rd Ste 101
Deerfield Beach, FL 33064-1370
Phone
(954) 888-3800
Fax
(954) 888-3808
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 02002597A IN
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 34-00-7236-Z OH
Otolaryngology Physician 207Y00000X OS14031 FL Primary

Addresses

Primary practice location

1801 W Sample Rd Ste 101
Deerfield Beach, FL 33064-1370

Mailing address

1700 NW 49TH St Ste 125
Fort Lauderdale, FL 33309-3750
Phone (954) 888-3800

Other identifiers 1

IdentifierTypeStateIssuer
017597600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040824000836 IN Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 6901870088 Reassigns benefits to 1 organization
I20160707002065 FL Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 6901870088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Ohio State University College of Homeopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Surgical Specialists LLCGroup PAC ID 5799881660, 91 clinicians

Practice addresses (Care Compare)

3536 N Federal Hwy
Suite 102
Fort Lauderdale, FL 33308-6264
Phone (954) 308-3349

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073
  • Broward Health North Hospital, Deerfield Beach, FL, CCN 100086

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Indiana ENT, LLC Otolaryngology CurrentSince Feb 6, 2025 Accepting new patients
Florida Hospital Physician Group Inc Otolaryngology CurrentSince Jul 30, 2024 Accepting new patients
South Florida Surgical Specialists LLC CurrentSince Nov 14, 2022 Accepting new patients
Otolaryngology Associates, LLC Otolaryngology Past Accepting new patients
Dayton Head and Neck Surgeons Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

3536 N Federal Hwy
Ste 102
Ft Lauderdale, FL 33308
Phone (888) 620-7245

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

1655 N Gladstone Ave
Ste E
Columbus, IN 47201
Phone (812) 376-3071

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: charleszeller@face.ssdirect.aprima.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IEEADA
  • FHIR API: https://api.platform.athenahealth.com/12832/brand/1/csg/1/fhir/r4

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 6

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1720086366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-888-3800",
            "fax_number": "954-888-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W SAMPLE RD STE 101",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330641370",
            "telephone_number": "954-888-3800",
            "fax_number": "954-888-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "02002597A",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "OH",
            "license": "34-00-7236-Z",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "OS14031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017597600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.