NPIMap

Individual provider Active NPI

Zachary Stephan

  • Family Medicine Physician
  • Maumee, OH
National Provider Identifier
1750745782
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35134017 Issued in OH
Practice address
660 Beaver Creek Cir Ste 110
Maumee, OH 43537-1746
Phone
(419) 891-6210
Fax
(419) 893-3232
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 35134017 OH Primary

Addresses

Primary practice location

660 Beaver Creek Cir Ste 110
Maumee, OH 43537-1746

Mailing address

660 Beaver Creek Cir Ste 110
Maumee, OH 43537-1746
Phone (419) 891-6210

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zstephan47658@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190729002963 OH Practitioner - Family Practice 3375836398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

660 Beaver Creek Cir
Suite 110
Maumee, OH 43537-1746
Phone (419) 891-6210

Hospital & facility affiliations

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 Medicine

State licenses

LicenseStateTypeSpecialty
35134017OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2019 Accepting new patients

Locations

660 Beaver Creek Cir
Ste 110
Maumee, OH 43537
Phone (419) 891-6210

5901 Monclova Rd
Maumee, OH 43537
Phone (419) 893-5911

5705 Monclova Rd
Maumee, OH 43537
Phone (419) 893-3321

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Interoperability endpoints

  • Direct secure messaging: zstephan47658@direct.promedica.org

Organizations & group practices 2

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 8

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1750745782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BEAVER CREEK CIR STE 110",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371746",
            "telephone_number": "419-891-6210",
            "fax_number": "419-893-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BEAVER CREEK CIR STE 110",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371746",
            "telephone_number": "419-891-6210",
            "fax_number": "419-893-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35134017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zstephan47658@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.