Individual provider Active NPI

Jeffrey Adam Zisk, M.D.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1740309038
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75952 Issued in MA
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(877) 866-7123
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 75952 MA
Family Medicine Physician 207Q00000X 75952 MA Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

180 Rock Island Rd
Quincy, MA 02169-3841
Phone (617) 773-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130531000387 MA Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 1951549062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
University of Massachusetts Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vohra Post Acute Care Physicians of the Northeast PAGroup PAC ID 9335378066, 34 clinicians

Practice addresses (Care Compare)

945 Concord St
Framingham, MA 01701-4613
Phone (877) 866-7123

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1554
Removal of skin lesions104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75952MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Post Acute Care Physicians of the Northeast PA Family Medicine CurrentSince Dec 1, 2014 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

945 Concord St
Framingham, MA 01701
Phone (203) 598-6045

Organizations & group practices 1

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1740309038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ROCK ISLAND RD",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021693841",
            "telephone_number": "617-773-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZISK",
        "first_name": "JEFFREY ADAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "75952",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "75952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.